Cost of illness in a super-aged society—comparison of breast, lung, and prostate cancer in Japan

Abstract

Background Aging increases the disease burden because of an increase in disease prevalence and mortality among older individuals. This could influence the perception of the social burden of different diseases and treatment prioritization within national healthcare services. Cancer is a disease with a high disease burden in Japan; however, the age-specific frequency and age-specific mortality rates differ according to site. In this study, we evaluated the relationship between the aging of the Japanese society and the disease burden by comparing the features of three cancers with different age-specific frequency rates in Japan. Furthermore, we made projections for the future to determine how the social burden of these cancers will change. Methods We calculated the social burden of breast, lung, and prostate cancers by adding the direct, morbidity, and mortality costs. Estimates were made using the cost of illness (COI) method. For future projections, approximate curves were fitted for mortality rate, number of hospital admissions per population, number of outpatient visits per population, and average length of hospital stay according to sex and age. Results The COI of breast, lung, and prostate cancers in 2017 was 903.7, 1,547.6, and 390.8 billion yen, respectively. Although the COI of breast and prostate cancers was projected to increase, that of lung cancer COI was expected to decrease. In 2017, the average age at death was 68.8, 76.8, and 80.7 years for breast, lung, and prostate cancers, respectively. Conclusions Patients with breast cancer die earlier than those with other types of cancer. The COI of breast cancer (“young cancer”) was projected to increase slightly because of an increase in mortality costs, whereas that of prostate cancer (“aged cancer”) was projected to increase because of an increase in direct costs. The COI of lung cancer (“aging cancer”) was expected to decrease in 2020, despite the increase in deaths, as the impact of the decrease in human capital value outweighed that of the increase in deaths. Our findings will help prioritize future policymaking, such as cancer control research grants.

The usage and costs of national drug price-negotiated anticancer medicines in a first-tier city in Northeast China: a study based on health insurance data

“…In comparing the frequencies of medical insurance claims and the costs of other diseases, lung cancer (32.1% and 22.1%, respectively) has the highest proportion and the most noticeable growth trend, followed by breast cancer (7.0% and 8.3%, respectively). Related studies have drawn similar conclusions [39][40][41][42]. Thirdly, policy and market factors can influence the pricing of new drug [43] and contribute to higher drug costs, such as lower prices of drugs after they are included in medical insurance, leading to a significant increase in demand.…”

Cost of illness for colorectal cancer in Japan - a time trend and future projections (1996–2035) based on governmental statistics

“…The rank order of incidence of cancer by site in Japan is colon, lung, stomach, breast, and prostate from first to fifth, and the rank order of death is lung, colon, stomach, pancreas, and liver, in that order. The authors have estimated the COI of these cancers, excluding pancreatic cancer [ 32 , 35 , 36 ]. Among these cancers, stomach and liver cancers have already shown a decrease in COI and are expected to decrease further in the future.…”

“…Future estimates of direct costs were obtained by dividing historical direct costs into inpatient and outpatient costs, dividing each by the total number of inpatient days and outpatient visits to obtain unit costs, estimating the trend using an exponential/logarithmic approximation curve, and multiplying by the estimated total number of inpatient days and outpatient visits to obtain a total sum. Details of the actual COI calculation methodology are detailed in Matsumoto (2022) [ 32 ]. In addition, the impact of the recent spread of colorectal cancer screening was considered using the available incidence data by stage according to UICC-TNM classification from 2008 to 2019.…”

Treatment Strategies for High-Risk Prostate Cancer - Utility of Combination Therapy of Neoadjuvant Therapy and Radical Prostatectomy to Improve Oncologic Outcomes

“…An estimated 268,490 patients in the United States and 94,748 patients in Japan were expected to be newly diagnosed with prostate cancer (PCa) in 2022 and 2019, respectively [1,2]. Most patients with PCa are older than 65 years, and this disease is most commonly found in male patients [1,2].…”

“…An estimated 268,490 patients in the United States and 94,748 patients in Japan were expected to be newly diagnosed with prostate cancer (PCa) in 2022 and 2019, respectively [1,2]. Most patients with PCa are older than 65 years, and this disease is most commonly found in male patients [1,2]. PCa progresses relatively slowly, and approximately 85% of patients with prostate cancer are diagnosed with low-risk or intermediate-risk diseases according to several guidelines; therefore, the prognosis for PCa without metastases is recognized as having relatively be er oncological outcomes, including be er overall survival (OS), cancer-specific survival (CSS), prostate cancer-specific mortality (PCSM), metastatic-free survival (MFS), and biochemical recurrence-free survival (BRFS) [3][4][5][6][7].…”