Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
Cancer Med. 2023 Nov;12(22):21022-21031. doi: 10.1002/cam4.6660. Epub 2023 Oct 30.
Rising costs of cancer treatments challenge even areas with universal health coverage. There's a need to assess current medical care utilization trends among patients with cancer to guide public health policy, resource allocation, and set informed healthcare goals.
We analyzed the latest trends in medical care utilization by cancer patients in four areas-drugs, radiation therapy (RT), surgery, and diagnostic procedures-using clinical databases extracted from electronic medical records of a tertiary hospital in Korea between 2014 and 2019. Compound adjusted growth rates (CAGR) were computed to capture the annual growth over the study period.
A total of 74,285 cancer patients were identified, with 40.3% (29,962), 14.2% (10,577), 31.1% (23,066), and 92.6% (68,849) of patients having received at least one anticancer agent, RT, surgery, and diagnostic procedure, respectively, over the period. We observed a 1.7-fold increase in the use of targeted · immune-oncology agents (from 6.8% to 11.6%) and a 21-fold increase (from 3.0% in 2014 to 65.7%) in intensity-modulated RT (IMRT) use over the period. In contrast, we observed a continuous decrease in the proportion of patients who underwent surgical treatment from 12.2% in 2014 to 10.9% in 2019. This decrease was particularly noticeable in patients with colon cancer (from 28.5% to 24.2%) and liver cancer (from 4.1% to 2.9%).
From 2014 to 2019, there was a significant rise in the use of targeted · immune-oncology agents and IMRT, alongside a decline in surgeries. While targeted · immune-oncology agents and IMRT may offer promising outcomes, their financial impact and potential for overuse necessitate careful oversight and long-term cost-effectiveness studies.
癌症治疗费用的上涨即使在拥有全民医保的地区也构成了挑战。有必要评估癌症患者当前的医疗服务利用趋势，以指导公共卫生政策、资源配置，并设定明智的医疗保健目标。
我们使用从韩国一家三级医院的电子病历中提取的临床数据库，分析了 2014 年至 2019 年期间癌症患者在药物、放射治疗 (RT)、手术和诊断程序四个方面的医疗服务利用最新趋势。复合调整增长率 (CAGR) 用于捕获研究期间的年度增长。
共确定了 74285 例癌症患者，其中 40.3%（29962 例）、14.2%（10577 例）、31.1%（23066 例）和 92.6%（68849 例）的患者在该期间至少接受过一种抗癌药物、RT、手术和诊断程序。我们观察到靶向·免疫肿瘤学药物的使用增加了 1.7 倍（从 6.8%增加到 11.6%），调强放射治疗 (IMRT) 的使用增加了 21 倍（从 2014 年的 3.0%增加到 65.7%）。相比之下，我们观察到手术治疗的患者比例连续下降，从 2014 年的 12.2%下降到 2019 年的 10.9%。在结肠癌（从 28.5%下降到 24.2%）和肝癌（从 4.1%下降到 2.9%）患者中，这种下降尤为明显。
从 2014 年到 2019 年，靶向·免疫肿瘤学药物和 IMRT 的使用显著增加，而手术治疗则有所减少。虽然靶向·免疫肿瘤学药物和 IMRT 可能提供有前景的结果，但它们的财务影响和过度使用的潜力需要仔细监督和长期的成本效益研究。
