Department of Health Management and Health Economics, University of Oslo.
Oslo Economics, Oslo.
Medicine (Baltimore). 2021 Jul 2;100(26):e26523. doi: 10.1097/MD.0000000000026523.
Valid estimates of cancer treatment costs are import for priority setting, but few studies have examined costs of multiple cancers in the same setting.We performed a retrospective population-based registry study to evaluate phase-specific (initial, continuing, and terminal phase) direct medical costs and lifetime costs for 13 cancers and all cancers combined in Norway. Mean monthly cancer attributable costs were estimated using nationwide activity data from all Norwegian hospitals. Mean lifetime costs were estimated by combining phase-specific monthly costs and survival times from the national cancer registry. Scenarios for future costs were developed from the lifetime costs and the expected number of new cancer cases toward 2034 estimated by NORDCAN.For all cancers combined, mean discounted per patient direct medical costs were Euros (EUR) 21,808 in the initial 12 months, EUR 4347 in the subsequent continuing phase, and EUR 12,085 in the terminal phase (last 12 months). Lifetime costs were higher for cancers with a 5-year relative survival between 50% and 70% (myeloma: EUR 89,686, mouth/pharynx: EUR 66,619, and non-Hodgkin lymphoma: EUR 65,528). The scenario analyses indicate that future cancer costs are highly dependent on future cancer incidence, changes in death risk, and cancer-specific unit costs.Gender- and cancer-specific estimates of treatment costs are important for assessing equity of care and to better understand resource consumption associated with different cancers.Cancers with an intermediate prognosis (50%-70% 5-year relative survival) are associated with higher direct medical costs than those with relatively good or poor prognosis.
有效的癌症治疗成本估算对于优先事项的设定至关重要，但很少有研究在同一环境中考察多种癌症的成本。我们进行了一项回顾性基于人群的登记研究，以评估挪威 13 种癌症和所有癌症的特定阶段（初始阶段、持续阶段和终末期）直接医疗成本和终身成本。使用来自所有挪威医院的全国性活动数据估算每月癌症归因成本的平均值。通过将特定于阶段的每月成本与国家癌症登记处的生存时间相结合，估算了终身成本。通过终身成本和 NORDCAN 估计的 2034 年预期新癌症病例数，制定了未来成本的情景。对于所有癌症的组合，在最初的 12 个月中，每位患者的直接医疗费用（按贴现计算）为 21808 欧元（EUR），在随后的持续阶段为 4347 欧元，在终末期（最后 12 个月）为 12085 欧元。5 年相对生存率在 50%-70%之间的癌症（骨髓瘤：EUR89686、口腔/咽：EUR66619、非霍奇金淋巴瘤：EUR65528）的终身成本更高。情景分析表明，未来的癌症成本高度取决于未来的癌症发病率、死亡风险变化和特定于癌症的单位成本。治疗成本的性别和癌症特异性估计对于评估护理公平性以及更好地了解与不同癌症相关的资源消耗非常重要。预后中等（5 年相对生存率 50%-70%）的癌症与相对较好或较差预后的癌症相比，直接医疗成本更高。
