Total Costs Distribution for Multiple Myeloma in Single Upper Middle Income Country: Is Cost Data Distribution Comparable with High Income Countries?

Abstract

ObjectiveS: According to World Bank, the Slovak Republic is an upper middle income country with a Gross National Income (GNI) per capita of US $3,950. The objective of this study was to calculate the total costs associated with MM. Subsequently, to evaluate the extent to which it is possible to obtain correct and reliable data from publicly available sources and compare cost data distribution with published MM studies from high income countries (e.g. US, EU). MethOdS: It was the retrospective analysis, conducted by using available electronic databases and direct data requests to state authorities. The "bottom-up" approach was performed that helped identify, quantify and value resources in a disaggregated way, so that each element of the costs was estimated individually and they were summed up at the end. Total costs were calculated for a model patient with MM during the first 12 months after confirmed diagnosis. ReSultS: The analysis showed that direct health care costs created 34% (€ 69 633) of total costs (€ 203 178) compare to 40% published by Ramon et al (2013) in EU. The indirect costs associated with cancer were the biggest part of the total costs (66%; € 133 534.60 for MM in Slovakia) in line with results by Ramon et al (2013). According to Fonseca et al (2017) MM treatment-related drug costs accounted for 28.5% in 2014 of total costs, which was similar to our analysis (21%, € 41 743) of total costs (€ 203 178). cOncluSiOnS: We found comparable distribution in costs for MM, considering methodology limitations across jurisdictions. Our study confirmed high difficulty in obtaining reliable cost data and results should be interpreted with caution. However, the study gives important feedback on cost data quality and availability in Slovakia, which have irreplaceable role in decision making process in healthcare.

Economic aspects of multiple myeloma: real costs associated with disease in the Slovak Republic

“…The imputed value of foreg or services become inefficient or are withdrawn from production on account of morbidity or premature mortality is widely regarded as an indirect cost [21]. Usually, the key stakeholders consider the direct medical costs only [22][23][24], but for full picture we also need to consider the indirect costs [25,26] paid by payers that create inevitable part of total costs evaluation.…”