Assessment of Cancer Care Costs in Disease-Specific Cancer Care Pathways

Abstract

<jats:p>In view of an efficient use of the Italian National Health Service-funded healthcare resources, a novel data-processing strategy combining information from multiple sources was developed in a regional cancer network of northern Italy. The goal was to calculate the annual overall cost of care pathways of six disease groups in 10,486 patients. The evaluation was conceived as a population-based cost description from the perspective of the Italian National Health Service. Costs occurred during a defined time period for a cross-section of patients at varying stages of their disease were measured. The total cancer care cost was €81,170,121 (11.1% of total local health expenditure), with a cost per patient of €7741.17 and a cost per capita of €204.62. Surgical, inpatient and day-hospital medical admissions, radiotherapy, drugs, outpatient care, emergency admissions, and home and hospice care accounted for 21.2%, 24.1%, 6.2%, 28.2%, 14.0%, 0.9%, and 5.4% of the total cost, respectively. The highest cost items included drugs (cost per capita, €22.95; 11.2% of total cost) and medical admissions (€14.51; 7.1%) for blood cancer, and surgical (€14.56; 7.1%) and medical admissions (€13.60; 6.6%) for gastrointestinal cancer. The information extracted allows multidisciplinary cancer care teams to be more aware of the costs of their clinical decisions.</jats:p>

The Economic Impact of Rectal Cancer: A Population-Based Study in Italy

“…Results show that average costs per patient have a U-shape: costs are higher in the first 2–3 months, when diagnostic tests and major surgeries are supplied, as well as in the end-of-life, when palliative care is supplied. Similar results are found elsewhere [ 16 , 33 , 34 ]. In the initial phase of care, hospitalization costs are highest in the first two months after diagnosis.…”

Financial Toxicity Related to Advanced Cancer Patients’ Care: Case study of Selected Households of Kiambu County, Kenya

“…Kenyans of all ages and socioeconomic backgrounds are adversely affected by Cancer. The majority of cancer cases are discovered at an advanced stage, when treatment choices are restricted, resulting in a poor prognosis and a high death rate (Altini, Solinas et al 2020). Family members experience financial toxicity related to adverse outcome of treatment of advanced cancer patient.…”

“…The escalating expense of cancer treatment has placed a significant financial strain on affected families, resulting in disastrous outcomes and destitution. According to one study, patients in the lowest income quartile and those under the age of 65 have a higher chance of incurring both catastrophic health expenditure (CHE) and distress financing (DF) (Altini, Solinas et al 2020). Financial toxicity is becoming more recognized as adverse outcome of cancer treatment.…”

“…Studies reviewed on cost-effectiveness analysis in cancer care report feasible models, initiatives and strategies that cushion families against financial toxicity (Chang and Abbott 2016, Carrera, Kantarjian et al 2018, Altini, Solinas et al 2020. Proposed ways include ccontinued funding of biomedical research and pharmaceuticals that will be more objective on establishing return on investment for any given treatment modality, and cost-effectiveness analyses that will be instrumental in providing solutions to the inequalities in healthcare delivery.…”

Factors influencing the delivery of cancer pathways: a summary of the literature

“…A care pathway can be defined as a general clinical plan that maps the trajectory of the patient through the healthcare system ( Altini et al , 2020 ; Schrijvers et al , 2012 ). As such, it involves many activities and can be seen as a complex adaptive system that responds to medical decisions, patient outcomes and local characteristics, among other factors.…”