Estimation of Socioeconomic Burden of Lung Cancer in the Russian Federation

The aim of this study was to estimate the socio-economic burden of lung cancer (LC) in the Russian Federation. Methodology: the social burden of LC is defined as the number of patients newly diagnosed with LC in 2016, those who are followed-up in oncology clinics, disabled and deceased persons. The economic burden consists of total direct and indirect costs associated with LC and estimated from a government perspective. Direct medical costs include costs for diagnosis, inpatient and outpatient treatment, palliative care, follow-up costs, and expenditures for the subsidized drug coverage. Direct non-medical costs include payments for sickness and disability caused by LC. Indirect costs were calculated as a loss of a gross domestic product due to LC morbidity and mortality. Calculations were based on the methods described in Ignatieva V. I. et al. (2014) and adapted by the authors of this study to new methods of inpatient medical care payment. Indirect costs were calculated by the friction cost method. The sensitivity analysis was conducted to estimate the impact of initial parameters` variations, as well as the impact of indirect costs estimation with the human capital methods, on the results. Results. In 2016, medical care was provided to 185,631 patients with LC, of whom 51,768 (27.9%) were newly diagnosed during the year. Direct medical costs were about 6.83 billion rubles. Most costs were incurred in inpatient care (4.09 billion rubles, 60.0%) and for the subsidized drug coverage (1.49 billion rubles, 21.8%). Direct non-medical expenses were about 5.76 billion rubles, 5.16 billion (89.7%) were disability-related payments. Indirect costs were about 14.77 billion rubles (friction cost method).

The cost of Lyme borreliosis

Background: Lyme borreliosis (LB) is the most frequently reported tick-borne infection in Europe and North America. The aim of this study was to estimate the cost-of-illness of LB in the Netherlands. Methods: We used available incidence estimates from 2010 for tick bite consultations and three symptomatic LB outcomes: erythema migrans (EM), disseminated LB and Lyme-related persisting symptoms. The cost was estimated using these incidences and the average cost per patient as derived from a patient questionnaire. We estimated the cost from a societal perspective, including healthcare cost, patient cost and production loss, using the friction cost method and a 4% annual discount rate. Results: Tick bites and LB in 2010 led to a societal cost of €19.3 million (95% CI 15.6–23.4; 16.6 million population) for the Netherlands. Healthcare cost and production loss each constituted 48% of the total cost (€9.3 and €9.2 million/year), and patient cost 4% (€0.8 million/year). Of the total cost, 37% was related to disseminated LB, followed by 27% for persisting symptoms, 22% for tick bites and 14% for EM. Per outcome, for an individual case the mean cost of disseminated LB and Lyme-related persisting symptoms was both around €5700; for EM and GP consultations for tick bites this was €122 and €53. As an alternative to the friction cost method, the human capital method resulted in a total cost of €23.5 million/year. Conclusion: LB leads to a substantial societal cost. Further research should therefore focus on additional preventive interventions.