Lévy Christine, Bonastre Julia
Service d'information médicale, Institut Gustave-Roussy, 39 rue Camille-Desmoulins, 94805 Villejuif, France.
Bull Cancer. 2003 Nov;90(11):976-82.
Health expenditures keep increasing regularly for many years and the medical cost of cancer as well. French Social Security estimated in 1994 that reimbursed health care expenditures for cancer reached 5.3 billions euros (8% of health care budget). Two French studies based on 1996 and 1999 diagnosis related groups data suggest that 15 % to 25 % of stays in public hospitals are related to cancer. In these studies, the budget of public health system for cancer was estimated to 6 billions euros, among which chemotherapy accounted for 16% to 18%. French Health authorities data show that pharmaceutical sales for anticancer drugs, which are mainly delivered in the hospital sector (70%) are around 1.5 billion euros in 2002. The price of the new drugs explains a part of the burden of cancer in France as in the other countries. However other factors need to be highlighted especially the increasing incidence of cancer, the ageing of population and the enlarged number of eligible patients for chemotherapy. Finally, one should note that current French reimbursement system for chemotherapy modifies the management of patients (day care versus inpatient care) and the repartition of care between the public and private sectors.
多年来，医疗支出持续有规律地增长，癌症的医疗费用亦是如此。法国社会保障部门在1994年估计，癌症的医保报销支出达53亿欧元（占医疗预算的8%）。两项基于1996年和1999年诊断相关组数据的法国研究表明，公立医院15%至25%的住院病例与癌症有关。在这些研究中，公共卫生系统用于癌症的预算估计为60亿欧元，其中化疗占16%至18%。法国卫生当局的数据显示，2002年主要在医院部门发放（70%）的抗癌药物销售额约为15亿欧元。与其他国家一样，新药价格是法国癌症负担的一部分原因。然而，其他因素也需要强调，尤其是癌症发病率上升、人口老龄化以及符合化疗条件的患者数量增加。最后，应该指出的是，法国目前的化疗报销制度改变了患者的治疗管理方式（日间护理与住院护理）以及公共和私营部门之间的医疗分配。
