Cost of illness of urothelial bladder cancer in Italy.
Cost of illness of urothelial bladder cancer in Italy.
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DOI：
10.2147/ceor.s135065
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Teruzzi C
中科院分区：
文献类型：
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作者：
Gerace C;Montorsi F;Tambaro R;Cartenì G;De Luca S;Tucci M;Martorana G;Basso U;Cardosi L;Teruzzi C
尿路上皮性膀胱癌（UBC）是全球第九大常见癌症。在意大利，该疾病的患病率约为10%，使其成为该国第四大最流行的癌症。发病率的增加需要持续的监测和护理，这给意大利国家卫生服务系统造成了沉重的负担，因此对这种疾病的诊断和治疗战略的任何改进对医学界和科学界都很重要。本研究的目的是评估意大利背景下UBC的疾病成本，收集疾病的总成本。利用从六个中心收集的数据，在国民保健制度的背景下进行了经济分析，以评估门诊、住院和急诊护理方面的直接成本；药品和后续程序；以及生产力损失方面的间接成本。数据通过汇总形式报告收集，重点关注去年接受治疗的现有诊断为UBC的患者。意大利肿瘤医学协会（AIOM）指南用于确定诊断和治疗程序。统计分析各中心间的差异。每位患者的加权平均年总费用为3591欧元，其中浅表疾病的费用为3252欧元，转移性疾病的费用为606欧元。分析证实了疾病严重程度和残疾等级之间的比例关系。考虑到2016年AIOM/意大利癌症登记协会报告的患病率和发病率数据，UBC的疾病成本为1,187,036,344欧元。间接成本占44%，以估计的生产力损失为代表。我们的分析代表了意大利背景下UBC的第一个经济研究，以及当前治疗算法的第一个现实证据。这项研究开启了进一步分析间接成本组成部分的可能性，这些间接成本构成了对社会的巨大负担，特别是对那些处于疾病最严重阶段、残疾程度高的人。
Urothelial bladder cancer (UBC) is the ninth most common cancer worldwide. In Italy, the prevalence of the disease is approximately 10%, making it the fourth most prevalent cancer in the country. The increase in prevalence requires continuous surveillance and care, resulting in a significant burden on Italian National Health Service, making any improvement to the strategy for diagnosing and treating this disease important to the medical and scientific community. The aim of this study was to evaluate the UBC cost of illness in the Italian context, collecting the total costs of the disease. An economic analysis was carried out in the context of the National Health Service, using data collected from six centers, in order to evaluate direct costs in terms of outpatient, inpatient, and emergency care; pharmaceuticals and follow-up procedures; and indirect costs in terms of productivity losses. Data were collected through aggregated form reports, focusing on patients with an existing diagnosis of UBC who were treated in the last year. The Italian Association of Medical Oncology (AIOM) guidelines were used to identify diagnostic and therapeutic procedures. Statistical analysis was conducted to explore variations among centers. The weighted mean total annual cost per patient was € 3,591, where the cost for superficial disease was € 3,252 and that for metastatic disease was € 606. The analysis confirmed a proportional relation between disease severity and disability grade. The UBC cost of illness, considering prevalence and incidence data coming from the 2016 AIOM/Italian Association of Cancer Registries report, was € 1,187,036,344. Indirect costs accounted to 44%, represented by estimated productivity losses. Our analysis represents the first economic study of UBC in the Italian context, as well as the first real-life evidence of the current therapeutic algorithm. This study opens the possibility for further analysis on the indirect cost components that represent a great burden for the society, especially for those in the severest stages of the disease with high disability grades.