[Cost aspects of oncologic chemotherapy].

The costs chemotherapy for eight patients with different diagnoses treated between 1983 and 1985 were analyzed, based on case histories and invoices submitted to medical insurance companies. Total monthly costs of therapy included drug costs, diagnostic costs, fees and hospital charges. The total monthly chemotherapy costs ranged between SFr. 379.- and SFr. 6065.- and between SFr. 874.- and SFr. 3476.- for 5 outpatients and two inpatients respectively. Total monthly drug costs ranged between SFr. 103.- (Fluorouracil) and SFr. 1744.- (Adriamycin) for palliative therapies, and between SFr. 620.- (MOPP-ABVD) and SFr. 2490.- (Cis-Platin, Velbe, Bleomycin) for curative therapies. The drug costs (Methotrexate) of a third inpatient exceeded the flat rate paid by insurance, the remaining costs being covered by the state. About 50% of cancer chemotherapy costs are due to drug costs. Drug costs of curative therapies seem to be higher than those of palliative therapies. A reduction of total costs by more than 30% is possible if hospitalisation is avoided, which might be inacceptable for some patients. Our method gives an incomplete picture of total chemotherapy-related costs because it does not consider loss of earnings and costs borne by the state to cover the deficit. Possibilities to reduce chemotherapy costs in tumor patients are discussed.