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中国肺癌的人群层面经济负担:基于2017-2030年临时患病率的估计

Population-level economic burden of lung cancer in China: Provisional prevalence-based estimations, 20172030.

作者信息

Liu Chengcheng, Shi Jufang, Wang Hong, Yan Xinxin, Wang Le, Ren Jiansong, Parascandola Mark, Chen Wanqing, Dai Min

机构信息

Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Tobacco Control Research Branch, Division of Cancer Control and Population Sciences/National Cancer Institute, Bethesda, MD 20852, USA.

出版信息

Chin J Cancer Res. 2021 Feb 28;33(1):79-92. doi: 10.21147/j.issn.1000-9604.2021.01.09.

Abstract

OBJECTIVE

Population-level economic burden is essential for prioritizing healthcare resources and healthcare budget making in the future. However, little is known about the economic burden of lung cancer in China.

METHODS

A prevalence-based approach was adopted to estimate the economic burden of lung cancer, including direct expenditure (medical and non-medical) and indirect cost (disability and premature death). Data on direct expenditure and work-loss days per patient in each year post-diagnosis were obtained from two primary surveys. Other parameters were obtained from literatures and official reports. Projections were conducted based on varying parameters. All expenditure data were reported in United States dollars (USD) using 2017 value (exchange rate: 1 USD= 6.760 CNY), with the discount rate of 3%.

RESULTS

The total economic burden of lung cancer was estimated to be 25,069 million USD in China in 2017 (0.121% of gross domestic productivity, GDP). The estimated direct expenditure was 11,098 million USD, up to 1.43% of total healthcare expenditure for China, covering 10,303 million USD and 795 million USD for medical and non-medical expenditure, respectively. The estimated indirect cost was 13,971 million, including 1,517 million USD due to disability and 12,454 million USD due to premature death. Under current assumptions, the projected total economic burden would increase to 30.1 billion USD, 40.4 billion USD, and 53.4 billion USD in 2020, 2025, and 2030, accounting for 0.121%, 0.131%, and 0.146% of China's GDP, respectively. However, if China meets the United Nation sustainable development goal of reducing premature death from non-communicable diseases by one-third by 2030, the total economic burden in 2030 would be 31.9 billion USD, 0.087% of China's GDP.

CONCLUSIONS

The economic burden of lung cancer in China in 2017 is substantial and more likely to increase significantly in the future. Policy makers need to take urgent actions in budget making for health systems. The economic burden could be alleviated by reducing the disease burden of lung cancer via effective control and prevention actions.

摘要

目的

人群层面的经济负担对于未来医疗资源的优先配置和医疗预算制定至关重要。然而,中国肺癌的经济负担情况鲜为人知。

方法

采用基于患病率的方法来估算肺癌的经济负担,包括直接支出(医疗和非医疗)和间接成本(残疾和过早死亡)。每年诊断后每位患者的直接支出和误工天数数据来自两项初步调查。其他参数来自文献和官方报告。基于不同参数进行了预测。所有支出数据均以2017年价值的美元(USD)报告(汇率:1美元 = 6.760人民币),贴现率为3%。

结果

2017年中国肺癌的总经济负担估计为250.69亿美元(占国内生产总值,GDP的0.121%)。估计的直接支出为110.98亿美元,占中国医疗总支出的1.43%,其中医疗支出为103.03亿美元,非医疗支出为7.95亿美元。估计的间接成本为139.71亿美元,包括因残疾导致的15.17亿美元和因过早死亡导致的124.54亿美元。在当前假设下,预计到2020年、2025年和2030年,总经济负担将分别增至301亿美元、404亿美元和534亿美元,分别占中国GDP的0.121%、0.131%和0.146%。然而,如果中国实现到2030年将非传染性疾病过早死亡减少三分之一的联合国可持续发展目标,2030年的总经济负担将为319亿美元,占中国GDP的0.087%。

结论

2017年中国肺癌的经济负担巨大,且未来很可能大幅增加。政策制定者需要在卫生系统预算制定方面采取紧急行动。通过有效的控制和预防行动减轻肺癌的疾病负担,可以缓解经济负担。

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