The efficiency of public policies includes the measurement of the health resources used and their associated costs. There is a lack of studies evaluating the economic impact of oral cancer (OC). This study aims to estimate the healthcare costs of OC in Brazil from 2008 to 2016. This is a partial economic evaluation using the gross costing top-down method, considering the direct healthcare costs related to outpatients, inpatients, intensive care units, and the number of procedures, from the perspective of the public health sector. The data were extracted from the Outpatient and Inpatient Information System of the National Health System, by diagnosis according to the 10th Revision of the International Classification of Diseases, according to sites of interest: C00 to C06, C09 and C10. The values were adjusted for annual accumulated inflation and expressed in 2018 I$ (1 I$ = R$2,044). Expenditure on OC healthcare in Brazil was I$495.6 million, which was composed of 50.8% (I$251.6 million) outpatient and 49.2% (I$244.0 million) inpatient healthcare. About 177,317 admissions and 6,224,236 outpatient procedures were registered. Chemotherapy and radiotherapy comprised the largest number of procedures (88.8%) and costs (94.9%). Most of the costs were spent on people over 50 years old (72.9%) and on males (75.6%). Direct healthcare costs in Brazil for OC are substantial. Outpatient procedures were responsible for the highest total cost; however, inpatient procedures had a higher cost per procedure. Men over 50 years old consumed most of the cost and procedures for OC. The oropharynx and tongue were the sites with the highest expenditure. Further studies are needed to investigate the cost per individual, as well as direct non-medical and indirect costs of OC.
Although clinical and epidemiological aspects of oral cancers (OC) are well-documented in the literature, there is a lack of evidence on the economic burden of OC. This study aims to provide a comprehensive systematic assessment on the economic burden of OC based on available evidence worldwide. A systematic review was conducted. The population was any individual, who were exposed to OC, considered here as lip (LC), oral cavity (OCC), or oropharynx (OPC) cancer. The outcome was information on direct (medical and non-medical) and indirect (productivity loss and early death) costs. The data sources included Scopus, Web of Science, Cochrane, BVS, and NHS EED. A search of grey literature (ISPOR and INAHTA proceedings) and a manual search in the reference lists of the included publications were performed (PROSPERO no. CRD42020172471). We identified 24 studies from 2001 to 2021, distributed by 15 countries, in 4 continents. In some developed western countries, the costs of LC, OCC, and OPC reached an average of Gross Domestic Product per capita of 18%, 75%, and 127%, respectively. Inpatient costs for OC and LC were 968% and 384% higher than those for outpatients, respectively. Advanced cancer staging was more costly (from ~22% to 373%) than the early cancer staging. The economic burden of oral cancer is substantial, though underestimated.
Background: Cancer care is among the costliest in the social sphere. Oral cancer (OC) is a chronic disease whose incidence has been growing worldwide. The lack of economic evaluation studies assessing the economic impact of OC, as well as the need to search for evidence of the economic burden of OC motivated this investigation. This study aims to collect evidence on the cost of OC (lip cancer - LC, oral cavity cancer - OCC and oropharyngeal cancer - OPC) worldwide. Methods: A systematic review will be conducted take into consideration any perspective. The primary outcome will be the costs related to oral cancer in patients, reported in monetary units. Specific breakdown of costs will be reported (direct hospital costs, rehabilitation care costs, direct non-healthcare costs, indirect costs and productivity loss, and intangible costs). SCOPUS, WEB OF SCIENCE, COCHRANE and BVS databases will be searched. Original studies on cost of OC that assess its cost based on components as: hospital and/or outpatient, promotion and prevention will be included. It will be excluded types of study such as: editorial, letters, reviews, case reports, case series, clinical trials, studies that address specific analysis, such as cost-effectiveness, cost-utility, cost-benefit, cost-minimization. A systematic meta-narrative synthesis will be presented. Data on quantities of health and social resource consumption, currencies used and whether studies show total or incremental costs will be collected.Discussion: The identification of evidence on the economic burden of LC, OCC and OPC will allow the determination of the contribution share of each sector of society in the total economic burden of oral cancer. Also, this evidence will favour the estimate of the impact that the reduction of the OC burden would have on its associated costs and better guide the choice decision, to optimize the benefits. Systematic review registration: PROSPERO ID number 172471.
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