Resource use and costs of newly diagnosed cancer initial medical care

Abstract

Aims: Assessment of direct medical costs of cancer diagnosis and treatment for newly diagnosed cancer patients; analysis of patterns of medical service utilization; description of costs according to ICD-10 diagnosis, age and stage at diagnosis; identification of major cost drivers; description of cost of terminal stage patients at the end of life. Material and methods: A retrospective, bottom-up database analysis was conducted on insurance claims and cancer registries. A payer’s perspective and six-month time span were adopted. Results: Duration of observation was 170+/-106 days (CI95%;164-176 ). A total of 1222 newly diagnosed cancer patients consumed on average € 6,837 (standard deviation [SD] € 24,523, range € 1-€ 438,042) per patient, in the first half year of treatment. Out of 151 deceased patients the mean survival time from diagnosis was 75+/-109 days (CI95%; 57-92). The mean cost of care was € 6,949 (SD € 36,414) per patient. Pharmaceuticals with monoclonal antibodies, in particular, were dominant among cost domains. The combined budget impact of this patient cohort was € 8,154,214 or € 6,837 per patient. Conclusion: The cost differentials of initial oncology diagnostics and treatment are substantial among major ICD-10 malignancy groups. The deceased - mostly late diagnosed, advanced stage patients - cost approximately twice in terms of terminal care compared to survivors, bearing in mind their short survival time. Evidence-based resource allocation in line with market demand for services will remain a key challenge in the provision of more effective and less costly oncology care in the Balkans.