Faculty of Pharmacy, Medical University-Pleven, 5800 Pleven, Bulgaria.
Faculty of Public Health "Prof. Tsekomir Vodenicharov, MD, DSc", Medical University of Sofia, 1527 Sofia, Bulgaria.
Int J Environ Res Public Health. 2023 Feb 3;20(3):2746. doi: 10.3390/ijerph20032746.
Bulgaria is among the European Union (EU) countries with the highest burden of cervical cancers and life expectancy below the EU average. The majority of cervical cancer cases (more than 95%) are caused by the human papillomavirus (HPV). The aim of this retrospective, cost of illness study is to identify direct healthcare costs of cervical cancer in Bulgaria from the payer perspective and to calculate indirect costs and the associated years of life lost. Costs data were sourced from the National Health Insurance Fund from January 2018 to December 2020. Years of life lost were calculated based on the country and gender-specific life expectancy. Indirect costs due to productivity loss were calculated using the human capital approach. The total treatment costs for 3540 patients with cervical cancer are EUR 5,743,657 (2018), EUR 6,377,508 (2019), and EUR 6,751,182 (2020). The costs associated with drug acquisition and administration accounted for the majority (63%) of total healthcare costs followed by hospital management costs (14%). An estimated total of 20,446 years of life were lost due to cervical cancer for the period 2018-2020. The costs of productivity losses are estimated at EUR 7,578,014. Our study showed that the economic burden of cervical cancer in Bulgaria is substantial. Focus on cervical cancer prevention via vaccination against the human papillomavirus, timely screening, early diagnosis, and higher vaccine coverage rates could reduce its economic burden in Bulgaria.
保加利亚是欧盟（EU）成员国中宫颈癌负担和预期寿命均低于欧盟平均水平的国家之一。大多数宫颈癌病例（超过 95%）是由人乳头瘤病毒（HPV）引起的。本回顾性疾病经济负担研究旨在从支付方的角度确定保加利亚宫颈癌的直接医疗保健成本，并计算间接成本和相关的生命损失年数。成本数据来源于 2018 年 1 月至 2020 年 12 月国家健康保险基金。基于国家和性别特异性预期寿命计算生命损失年数。因生产力损失而产生的间接成本采用人力资本法进行计算。3540 例宫颈癌患者的总治疗费用为 5743657 欧元（2018 年）、6377508 欧元（2019 年）和 6751182 欧元（2020 年）。药物获取和管理费用占总医疗保健成本的 63%，占比最大，其次是医院管理成本（14%）。2018-2020 年期间，宫颈癌导致的总生命损失估计为 20446 年。生产力损失成本估计为 7578014 欧元。本研究表明，保加利亚宫颈癌的经济负担相当沉重。通过 HPV 疫苗接种、及时筛查、早期诊断和提高疫苗接种率来预防宫颈癌，可以减轻保加利亚的经济负担。
