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Hematologic Cancers Among the Most Costly Malignancies to Treat

October 2016, Vol 7, No 9

The economic burden of hematologic cancers across European countries is considerable and outweighs the total cost of treating most other types of cancers, with the exception of breast cancer, according to a new population-based study based on data from 2012 (Burns R, et al.Lancet. 2016;3:e362-e370). The study also showed substantial variations in the costs of care among countries that did not always jibe with the level of wealth in a particular country.

In 2012, hematologic cancers cost the 28 countries in the European Union (EU), as well as Iceland, Norway, and Switzerland, €12 billion. Healthcare cost accounted for €7.3 billion (62% of the total costs), productivity losses cost €3.6 billion (30%), and informal care cost €1 billion (8%).

Looking only at the EU countries, hematologic cancers accounted for €6.8 billion of the total €57 billion (12%) healthcare expenditure on cancer, which is second only to breast cancer in economic impact. The total cost of hematologic cancers in the EU were  €12 billion (8%) of the total €143 billion cost of cancer.

“Our results add to essential public health knowledge needed for effective national cancer-control planning and priorities for public research funding,” noted Richeal Burns, PhD, Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK, and colleagues. “We believe that our study will be relevant to European policy makers implementing affordable cancer care for their citizens.”

Although the costs of hematologic cancers have been assessed in individual European countries, this study is a comprehensive assessment across Europe of the total economic burden these disorders comprise.

“To our knowledge, our study is the first to provide cost estimates for malignant blood disorders in 31 European countries using the same methodological framework for each country,” the investigators noted.

The healthcare costs per prevalent case of hematologic cancer were at least twice as high as the costs of the average expenditure across all sites of cancer in the 31 European countries and in the 28 EU countries.

“Healthcare costs per prevalent case are higher for malignant blood disorders because of higher and more frequent healthcare resource use, particularly higher than average length of stay compared with other cancers,” the investigators noted. They estimated that the average length of an inpatient stay was 14 days for hematologic cancers compared with 8 days for all other cancers, which was consistent across all 28 countries in the EU.

Compared with other cancer types, most hematologic cancers are treated with complex, long-term regimens that include bone marrow transplants, multidrug chemotherapy, and radiotherapy, and require extensive inpatient diagnostic and prognostic procedures for pathology and imaging, necessitating recurrent hospital stays and clinic visits, the researchers noted.

The healthcare costs per prevalent case varied substantially among the various countries, warranting further studies. A 10-fold difference was observed between the lowest and highest individual country costs.

The relative total costs of care for hematologic cancers in the EU were lower than those for lung, breast, and colorectal cancers, but the ranking shifted when the researchers considered total healthcare expenditure. Breast cancer accounted for 13% of all cancer types, followed by hematologic cancers (12%), colorectal cancer (11%), and prostate cancer (11%).

To put this in perspective, in the United States, lymphoma and leukemia had the highest (14%) cancer care costs of all cancer types, followed by breast (13%) and colorectal cancers (11%).

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