Academic journal article E+M Ekonomie a Management

The Costs and Reimbursements for Lung Cancer Treatment among Selected Health Care Providers in the Czech Republic

Academic journal article E+M Ekonomie a Management

The Costs and Reimbursements for Lung Cancer Treatment among Selected Health Care Providers in the Czech Republic

Article excerpt

Introduction

Lung cancer is the most frequently diagnosed oncologic disease worldwide. It is annually diagnosed in nearly 1.4 million patients. It is also the most frequent cause of cancer related deaths [32]. In the Czech Republic, lung cancer occupies a leading position both in the rate of incidence and the mortality rate. In men, it is the second most common oncologic disease after prostate cancer, while in women it assumes third position after breast and colon cancer [31]. Lung (bronchogenic) carcinoma are generally divided into two basic types: a group of non-small-cell lung cancers (NSCLC), which contributes to the total number of lung cancers at the level of 75 to 80%, and the small-cell lung cancer (SCLC) accounting for the remaining 20 to 25%. Both types differ from each other in regard to the biological behaviour and prognosis, as well as the treatment strategy [30], [31]. In 2010, the incidence of this disease in men was 89.7 per hundred thousand people (it was 102.3 in 1996), while in women it was 35.2 per hundred thousand people (against 22.9 in 1996). The severity of the disease is also reflected by the high mortality rate which was 74.8 per hundred thousand people in men in 2010 (87.9 in 1996) and 27.4 per hundred thousand people in women (19.5 in 1996) [28].

Cancer costs the EU are estimated as 126 billion EUR in 2009, with health care accounting for 51 billion EUR. Lung cancer had the highest economics cost 18.8 billion EUR. [11]. Up until this point (second part of the year 2013), no comprehensive study of healthcare costs for lung cancer treatment in all stages of the illness has been published in the Czech Republic. The main object of this study is to make an assessment of therapy related costs from the payers' (health insurance funds) and the healthcare providers' (hospitals) perspective based on some available and identifiable data from three out of total thirteen Complex Oncology Centres in the Czech Republic, namely Brno, Hradec Kralove and Plzen, where the treatment standards were set up [5], [20], [21], [30].

Several international studies have been carried out in the European context using, as a rule, so-called treatment algorithms for the determination of therapeutic costs [1]. Based on these algorithms, prices were successively analysed applying mainly the analysis of reimbursements based on DRG or on published reimbursement lists [14], [25], [29]. All the studies mentioned here are based on cost estimates. German study assessing the social costs employed the principle based on assessing the rate of human capital. The total costs, including the absenteeism costs, were thereby assessed. [27]. A retrospective study carried out in the Netherlands assessed costs from the initial diagnosis to subsequent death or to the end of the assessment period. It included the length of hospital stays, the types and number of diagnostic procedures involved and some information concerning radiotherapy and chemotherapy [23]. A very widespread approach is the assessment of treatment in a particular stage [1]. The authors of a study on this topic carried out in Switzerland came to the conclusion that a hospital stay is inexpedient in terms of cost effectiveness [9]. In the UK and the US, the so-called global studies analyse also the social costs of lung cancer [4]. The most extensive study of this type was published in the USA, by means of the application of diagnostic and therapeutic algorithms, the results of which were supported by data from a group of over 2,000 patients [15]. A study written in Thailand, describes a sample group of 96% of all patients with lung cancer registered there in 2010. The treatment costs were subdivided according to three schemes currently employed in Thailand for healthcare reimbursement [22].

According to Cipriano et al. [6], the monthly treatment costs for a 72-year-old patient diagnosed with lung cancer in 2000, ranged from USD 2,687 (no active treatment) to USD 9,360 (chemo-radiotherapy) in the first 6 months; costs varied by stage at diagnosis and histologic type. …

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