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[This corrects the article DOI: 10.1371/journal.pone.0214822.].
Citations
... Previous studies from China mainly focused on total direct medical expenditures during the inpatient phase [23] or the average medical expenditures associated with inpatient episodes [24][25][26][27][28]. To support comparison with existing studies, we also produced these results. ...
... Although previous studies that reported expenditures per inpatient episode were conducted in different areas of China [24][25][26][27][28], we found similar results that clinical stages and treatment methods were important predictors of direct medical costs associated with hospitalization (col. ...
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 follow-ups by Chinese cervical cancer treatment guidelines. Loss in quality-adjusted life years was obtained using the ‘under the curve’ method and regression predictions.
Results
A total of 3,506 inpatient records from 1,323 patients were obtained. Among 541 randomly selected patients, 309 completed at least one module of the telephone interview. The average total costs per case associated with cervical cancer from diagnosis to one year after final discharge ranged from $8,066-$22,888 (in 2018 US Dollar) and the quality-adjusted life years loss varied from 0.05–0.26 for IA-IV patients.
Conclusions
The economic burden associated with cervical cancer is substantial in Henan province. Our study provided important baseline information for cost-effectiveness analysis of HPV immunization program in China.
... per ICC patient from a societal perspective. Applying this annual per patient cost to the estimated incidence of 28 This discrepancy may be due to differences in costing methodologies, differences in time references, or to the great economic disparities between the regions in Brazil and abroad. 29 Radiotherapy expenditures accounted for the largest share of total costs (38.2%), followed by outpatient chemotherapy (27.4%). ...
Objective The main objective of the present study was to estimate the annual treatment costs of invasive cervical cancer (ICC) per patient at an oncology center in Brazil from a societal perspective by considering direct medical, direct nonmedical, and indirect costs.
Methods A cost analysis descriptive study, in which direct medical, direct nonmedical, and indirect costs were collected using a microcosting approach, was conducted between May 2014 and July 2016 from a societal perspective. The study population consisted of women diagnosed with ICC admitted to a tertiary hospital in Recife, state of Pernambuco, Brazil. The annual cost per patient was estimated in terms of the value of American Dollars (US$) in 2016.
Results From a societal perspective, the annual ICC treatment cost per patient was US$ 2,219.73. Direct medical costs were responsible for 81.2% of the total value, of which radiotherapy and outpatient chemotherapy had the largest share. Under the base-case assumption, the estimated cost to the national budget of a year of ICC treatment in the Brazilian population was US$ 25,954,195.04.
Conclusion We found a high economic impact of health care systems treating ICC in a poor region of Brazil. These estimates could be applicable to further evaluations of the cost-effectiveness of preventing and treating ICC.
Objective:
To evaluate cost of illness of locally advanced cervical cancer patients from societal perspective in three scenarios including completely cured without severe late side effects (S1), completely cured with late grade 3-4 gastrointestinal side effects (S2.1) or genitourinary side effects (S2.2), and disease recurrence and death (S3).
Methods:
The incidence-based approach was conducted. The cost was calculated for 5-year time horizon starting for the treatment initiation. Direct medical costs were extracted from hospital database. Cost of using two-dimensional technique and three-dimensional conformal radiation therapy were calculated separately. Direct non-medical costs and indirect costs in terms of productivity loss were based on actual expenses from the interview of 194 locally advanced cervical cancer patients from two tertiary hospitals in Bangkok, during June to December 2019. All costs were converted to US dollar in 2019 values.
Results:
For 5 years, cost of illness per patient for using two-dimensional technique and three-dimensional conformal radiation therapy were US $8,391 and US $10,418 for S1, US $18,018 and US $20,045 for S2.1, US $17,908 and US $19,936 for S2.2, and US $61,076 and US $63,103 for S3, respectively. The economic burden for newly diagnosed locally advanced cervical cancer patients in Thailand in 2018 was approximately US $129 million and US $131 million for using two-dimensional technique and three-dimensional conformal radiation therapy, respectively. Cost from S3 accounted for 70% of all total cost. Premature death was the most important cost driver of cost of illness accounted for 64 % of the total cost estimates.
Conclusions:
Cost of illness of locally advanced cervical cancer patients produced significant economic burden from societal perspective. Disease recurrence and early death from cancer was the most influential cause of this burden.
