End-of-life costs of medical care for advanced stage cancer patients

Abstract

Exactly 114 patients were analyzed, out of whom a high percent (48.25%) had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR) and the lowest (4.00 EUR) ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs), followed by oncology medical care (21%), radiation therapy and interventional radiology (11%), surgery (90%), imaging diagnostics (9%) and laboratory costs (8%). CONCLUSION. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients' quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency.

Macroeconomic Policy Impact On Oncology-Related Public Expenditure In An Emerging European Market – Signs Of Early Recovery

“…This pattern is consistent with previously published evidence on the region stating that particularly serious budget impacts were imposed by over-utilization of high-tech radiology imaging procedures (11,17,24). Pharmaceuticals were greatly influenced by novel, expensive biological treatments, such as monoclonal antibodies (mAbs) and protease inhibitors.…”

“…The early discovery of malignancies such as cervical, breast, colorectal, skin and gastric carcinomas prevents serious, expensive morbidities (49,50). The outcomes and success of late treatment of advance disease forms, including surgery, complimentary radiotherapy, cytostatic protocols and occasionally novel biologicals, are highly unpredictable (24). Life expectancy is usually low, and premature mortality has enormous ethical and economic consequences for the community.…”

“…Insufficient equipment capacities are common across the region (13,15). Due to a poor network of facilities across rural and remote regions of the Balkans and difficulty accessing specialist care, many patients seek treatment too late (24). Late treatment involves multiple radiotherapy sessions with modest or poor success (52).…”

“…Among the most frequently cited reasons for higher oncological mortality in Serbia are poverty, unhealthy lifestyles and ecological contamination due to the Chernobyl disaster and wars in Yugoslavia during the 1990s (21)(22). However, throughout Eastern Europe, poor implementation of screening procedures (23) and limited affordability of some innovative treatment technologies remain powerful contributors (24).…”

The aging of Europe. The unexplored potential

“…Most obvious one are higher medical needs of the people in their 70s and 80s [15]. This frequently accumulates to the fact that last years of life ending in an incurable illness demanding expensive intensive care unit admission, palliative or home care, costs more than the entire medical consumption of an individual over his/her life span [16]. Other less striking challenges refer to the difficulties in access to the medical care imposed to the elderly and concerning life quality in this age group.…”