Economic burden of cancers in Taiwan: a direct and indirect cost estimate for 2007–2017

ObjectiveCancers result in significant economic burdens on patients, health sectors and society. Reliable burden estimates will help guide resource allocation. This study aimed to perform a nationwide cost analysis of the direct and indirect costs of the top ten most costly cancers, and acute coronary syndrome (ACS), as a comparison, in Taiwan.SettingA population-based cohort study.ParticipantsIn total, 545 221 patients with newly diagnosed cancer (lung cancer, female breast cancer, colorectal cancer, liver cancer, oral cancer, leukaemia, prostate cancer, non-Hodgkin's lymphoma, gastric cancer and oesophageal cancer) and 170 879 patients with ACS between 2007 and 2014 were identified.Primary and secondary outcome measuresDirect medical costs were calculated from claims recorded in the National Health Insurance Research Database . Indirect costs, comprising morbidity-associated and mortality-associated productivity losses, were estimated from public life expectancy, average wage and employment data. The costs incurred in the 3 years after diagnosis were assessed. As a comparison, the cost of ACS was also estimated using the same study frame. A cost driver analysis was conducted to identify factors impacting cancer costs.ResultsThe cancers with the highest mean direct medical costs and total costs were leukaemia (US$28 464) and oesophageal cancer (US$81 775), respectively. Indirect costs accounted for over 50% of the total economic burden of most cancers, except for prostate cancer and female breast cancer. The costs of ACS were lower than those of most cancers. From the cost driver analysis, older age at diagnosis significantly (p<0.05) decreased the total cost of cancer; in contrast, male, tumour metastasis, comorbidities and treatment in medical centres increased the costs.ConclusionsThis study demonstrates the comprehensive economic burden of the top 10 most costly cancers in Taiwan. These results are valuable for optimising healthcare resource allocation.

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Changes in stage at diagnosis of screenable cancers after the Affordable Care Act.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.6521 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 6521-6521 ◽

Cited By ~ 3

Author(s):

Xuesong Han ◽

Chun Chieh Lin ◽

Ahmedin Jemal

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Colorectal Cancer ◽

Lung Cancer ◽

Cervical Cancer ◽

Cancer Patients ◽

Female Breast Cancer ◽

Stage I ◽

Stage At Diagnosis ◽

Female Breast

6521 Background: Extensive evidence links inadequate insurance with later stage at cancer diagnosis, particularly for cancers that can be detected by screening. The Affordable Care Act (ACA) implemented in 2014 has substantially increased insurance coverage for Americans 18-64 years old. This study aims to examine any changes in stage at diagnosis after the ACA for the following cancers for which screening is recommended for individuals at risk: female breast cancer, colorectal cancer, cervical cancer, prostate cancer, and lung cancer. Methods: We used National Cancer Data Base, a nationally hospital-based cancer registry capturing 70% new cancer cases in the US each year, to identify nonelderly cancer patients with screening-appropriate age who were diagnosed during 2013-2014. The percentage of stage I disease was calculated for each cancer type before (2013 Q1-Q3) and after (2014 Q2-Q4) the ACA. 2013 Q4-2014 Q1 was excluded as a washout/phase-in period. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated using log-binomial models controlling for age, race/ethnicity and sex if applicable. Results: 121,855 female breast cancer patients aged 40-64 years, 39,568 colorectal cancer patients aged 50-64 years, 11,265 cervical cancer patients aged 21-64 years, 59,626 prostate cancer patients aged 50-64 years, and 41,504 lung cancer patients aged 55-64 years were identified. After the implementation of the ACA, the percentage of stage I disease increased statistically significantly for female breast cancer (47.8% vs. 48.9%; PR = 1.02 [95%CI 1.01-1.03]), colorectal cancer (22.8% vs. 23.7%; PR = 1.04 [95%CI 1-1.08]), and lung cancer (16.6% vs. 17.7%; PR = 1.06 [95% CI 1.02-1.11]). A shift to stage I disease was also observed for cervical cancer (47.2% vs. 48.7%; PR = 1.02 [95% CI 0.98-1.06]) although not statistically significant. In contrast, the percentage of stage I decreased for prostate cancer (18.5% vs. 17.2%; PR = 0.93 [95%CI 0.9-0.96]) in 2014. Conclusions: The implementation of the ACA is associated with a shift to early stage at diagnosis for all screenable cancers except prostate cancer, which may reflect the recent US Preventive Services Task Force recommendations against routine prostate cancer screening.

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The economic burden of depression in Sweden from 1997 to 2005

European Psychiatry ◽

10.1016/j.eurpsy.2006.10.006 ◽

2007 ◽

Vol 22 (3) ◽

pp. 146-152 ◽

Cited By ~ 72

Author(s):

Patrik Sobocki ◽

Ingrid Lekander ◽

Fredrik Borgström ◽

Oskar Ström ◽

Bo Runeson

Keyword(s):

Sick Leave ◽

Economic Burden ◽

Early Retirement ◽

Indirect Costs ◽

Direct Costs ◽

Cost Driver ◽

Health Concern ◽

The Past ◽

Swedish Society ◽

The Cost

AbstractBackgroundDepression is one of the most common causes of disability and is associated with substantial reductions in the individual's quality of life. The aim of this study was to estimate the economic burden of depression to Swedish society from 1997 to 2005.Materials and MethodsThe study was conducted in a cost-of-illness framework, measuring both the direct cost of providing health care to depressive patients, and the indirect costs as the value of production that is lost due to morbidity or mortality. The costs were estimated by a prevalence and top-down approach.ResultsThe cost of depression increased from a total of €1.7 billion in 1997 to €3.5 billion in 2005, representing a doubling of the burden of depression to society. The main reason for the cost increase is found in the significant increase in indirect costs due to sick leave and early retirement during the past decade, whereas direct costs were relatively stable over time. In 2005, indirect costs were estimated at €3 billion (86% of total costs) and direct costs at €500 million (16%). Cost of drugs was estimated at €100 million (3% of total cost).ConclusionThe cost of depression is substantial to society and the main cost driver is indirect costs due to sick leave and early retirement. The cost of depression has doubled during the past eight years making it a major public health concern for the individuals afflicted, carers and decision makers.

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The cost-effectiveness of mammography-based female breast cancer screening in Canadian populations: a systematic review

10.1101/2020.01.18.20018044 ◽

2020 ◽

Author(s):

Talha Tahir ◽

Melanie Mitsui Wong ◽

Rabia Tahir ◽

Michael Mitsui Wong

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cost Effectiveness ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Cost Effective ◽

Female Breast Cancer ◽

Average Risk ◽

Female Breast ◽

The Cost

AbstractIntroductionMammography-based breast cancer screening is an important aspect of female breast cancer prevention within the Canadian healthcare system. The current literature on female breast cancer screening is largely focused on the health outcomes that result from screening. There is comparatively little data on the cost-effectiveness of the screening. Therefore, this paper sought to conduct a systematic review of the literature on the cost effectiveness of mammography-based breast cancer screening within female Canadian populations.Materials and methodsA systematic review was performed in the PubMed database to identify all studies published within the last 10 years that addressed breast cancer screening and evaluate cost-effectiveness in a Canadian population.ResultsThe search yielded five studies for inclusion, only three of which were applicable to average-risk Canadian women. The benefits of mortality reduction rose approximately linearly with costs, while costs were linearly dependent on the number of lifetime screens per woman. Moreover, triennial screening for average-risk women aged 50-69 years was found to be the most cost-effective in terms of cost per quality adjusted life year. The use of MRI in conjunction with mammography for women with the BRCA 1/2 mutation was found to be cost-effective while annual mammography-based screening for women with dense breasts was found to be cost-ineffective.ConclusionIn spite of the growing interest to enhance breast cancer screening programs, analyses of the cost-effectiveness of mammography-based screening within Canadian populations are scarcely reported and have heterogeneous methodologies. The existing data suggests that Canada’s current breast cancer screening policy to screen average-risk women aged 50-74, biennially or triennially is cost-effective. These findings could be of interest to health policy makers when making decisions regarding resource allocation; however, further studies in this field are required in order to make stronger recommendations regarding cost-effectiveness.

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