The economic burden of cervical cancer from diagnosis to one year after final discharge in Henan Province, China: A retrospective case series study

Abstract

Background In China, the disease burden of cervical cancer remains substantial. Human papillomavirus (HPV) vaccines are expensive and not yet centrally funded. To inform immunization policy, understanding the economic burden of the disease is necessary. This study adopted a societal perspective and investigated costs and quality of life changes associated with cervical cancer from diagnosis to one year after final discharge in Henan province, China. Methods Inpatient records of cervical cancer patients admitted to the largest cancer hospital in Henan province between Jan. 2017 and Dec. 2018 were extracted. A telephone interview with four modules was conducted in Jun.-Jul. 2019 with a 40% random draw of patients to obtain direct non-medical costs and indirect costs associated with inpatients, costs associated with outpatient visits, and changes in quality of life status using the EQ-5D-5L instrument. Direct medical expenditures were converted to opportunity costs of care using cost-to-charge ratios obtained from hospital financial reports. For each clinical stage (IA-IV), total costs per case from diagnosis to one year after final discharge were extrapolated based on inpatient records, responses to the telephone interview, and recommendation on outpatient followups by Chinese cervical cancer treatment guidelines. Loss in quality-adjusted life years was obtained using the 'under the curve' method and regression predictions.

The economic burden of cervical cancer in Eswatini: Societal perspective

“…This findings are consistent with those of previous studies whose findings suggest that costs of managing cervical cancer vary by cancer stage at diagnosis and that advanced cervical cancer (stages III and IV) poses the greatest costs [27][28][29][30]. Liu et al reported significant costs of cervical cancer in Canada and, according to these researchers, the average incremental costs increased with treatment phase (pre-diagnosis ($362), initial phase ($15,722), continuing phase ($3,924) and $52,539 in the terminal phase) [28].…”

“…This method discriminates individuals above retirement age and overestimates the costs of lost production because it disregards potential work replacement which eventually results in diminished production losses. Our proportion of the total annual costs constituted by indirect costs were consistent with those observed in other cost of illness studies [24,30,37,40].…”

A systematic review of financial toxicity among cancer patients in China

“…After removing duplicates, 7466 studies remained for relevancy screening, and 662 remained for full-text review. Finally, 13 articles published in Chinese and reporting 12 studies [29][30][31][32][33][34][35][36][37][38][39][40][41] and 18 articles published in English [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] were included in the review. Fig.…”

“…Of the 30 included studies, only 13 38,41,42,[46][47][48][49]52,53,[56][57][58][59] clearly defined the inclusion criteria; only 7 42,46,48,50,52,53,56 described the study subjects and settings in detail; and 3 36,39,41 were rated as "unclear" for statistical analysis, as they did not describe how the categorical variables were assigned values or how dummy variables were set for polytomous variables, although their selection of statistical analysis method (multiple linear regression) was appropriate. Of the 25 analytical cross-sectional studies, 29,31,[34][35][36][37][38][39][40][41][45][46][47][48][49][50][51][52][53][54][55][56][57][58]…”

Economic Evaluations of Cervical Cancer Screening Methods: a Systematic Review

“…The economic burden of cervical cancer is also substantial. For example, Wu et al (2020) reported that, in the Henan province of China, costs associated with cervical cancer, from diagnosis to one year after discharge, ranged from $8,066 to$22,888 per patient (4).…”