33 Background: Gastric cancer is one of the leading causes of cancer deaths in both sexes worldwide, especially in East Asia. This study aimed to estimate the economic burden of advanced gastric cancer (AGC) in Taiwan. Methods: The costs of AGC in 2013 were estimated using resource use data from a chart review study (n = 122 with AGC) and national statistics. Annual per-patient costs were estimated from 82 patients who had complete resource use data. The costs were composed of direct medical costs (inpatient, outpatients, and chemotherapy-related costs), direct non-medical costs (healthcare travel and caregiver costs), morbidity costs, and mortality costs. Relevant unit costs were retrieved mainly from literature and national statistics, and applied to the resource use data. Broad definitions of morbidity and mortality costs were employed to value the productivity loss in patients with unpaid employment, economically inactive and unemployed as well as the life years after the age of retirement. Narrow definitions were also used in sensitivity analyses, using age- and/or sex-specific employment rates. Forgone future earnings/productivity loss were discounted at 3%. Annual per-patient costs were projected to estimate the total costs of AGC at the national level with an estimated number of patients with AGC (N = 2,611) in 2013 in Taiwan. Results: The mean age of the 82 patients was 59.3 (SD: 11.9) years, and 67.1% were male. Per-patient costs were US$26,431 for direct medical costs, US$4,669 for direct non-medical costs, US$5,758 for morbidity costs, and US$145,990 for mortality costs (per death). These per-patient costs were projected to incur total AGC costs of US$423 million in 2013 in Taiwan. Mortality costs accounted for 77.3% of the total costs, followed by direct medical costs (16.3%), morbidity costs (3.6%), and direct non-medical costs (2.9%). Conclusions: The total costs of AGC in Taiwan were estimated to be about US$423million in 2013. Such high costs, despite relatively low AGC incidence/prevalence rates in Taiwan, were mainly due to high mortality rates and high mortality costs (per death). Reducing mortality rates and providing effective treatments may help to reduce its burden on patients, caregivers and society as a whole.
The Factors Associated With Direct Medical Costs in Patients With Gastric Cancer: Quantile Regression Approach Compared With Gamma Regression
