1
|
Azarbakhsh H, Rezaei F, Dehghani SS, Hassanzadeh J, Janfada M, Mirahmadizadeh A. Trend Analysis of Lung Cancer Mortality and Years of Life Lost (YLL) in South of Iran, 2004-2019. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:238-245. [PMID: 38694860 PMCID: PMC11058385 DOI: 10.18502/ijph.v53i1.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/19/2022] [Indexed: 05/04/2024]
Abstract
Background We aimed to determine the mortality rate and Years of Life Lost (YLL) due to lung cancer in Fars, Iran, during the period from 2004 to 2019. Methods All deaths due to lung cancer in Fars Province, Iran from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated and trends examined. Results During 2004-2019, 3346 deaths occurred due to lung cancer in Fars Province, which was 10.8% (3346/30936) of the total cancer deaths in this period. Crude mortality rate of lung cancer had increased 70% and 53% in male and female respectively from 2004 to 2019. The total YLL of lung cancer during the 16-year study period was 28,094 (0.9 per 1000) in men, 14,174 (0.5 per 1000) in women, and 42,268 (0.8 per 1000) in both sexes (sex ratio male/female=2). According to the join point regression, the 16- year trend of YLL rate due to premature mortality was increasing: APC was 2.5% (95% CI 0.9 to 4.2, P=0.005) for males, 1.4% (95% CI 0.3 to 2.6, P=0.017) for females. Conclusion The mortality rate and YLL due to lung cancer in Fars Province is increasing, although the standardized mortality has a constant trend. Tobacco control is the most effective and least expensive way to reduce the number of lung cancer patients worldwide. National and local media can also play an important role in informing people about the risk factors.
Collapse
Affiliation(s)
- Habibollah Azarbakhsh
- Department of Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Rezaei
- Research Center for Social Determinants of Health, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Jafar Hassanzadeh
- Department of Epidemiology, Institute of Health, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Janfada
- Medical Records, Health Vice-Chancellor, Shiraz University of medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
2
|
Youk TM, Hong JH, Park BK, Park YM, Park EC. Estimation of the Three Phases by Direct Cost of Care for Non-surviving Patients with Cancer: A National Population-based Patient-level Study. J Cancer 2024; 15:20-29. [PMID: 38164281 PMCID: PMC10751664 DOI: 10.7150/jca.78491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024] Open
Abstract
Background: Determining the cost structure of medical care from diagnosis to the death of patients with cancer is crucial for establishing budgets to support patients with cancer. The breakdown of the cost estimation in distinct phases of survival is essential for optimizing the allocation of limited funds. Therefore, this study aims to examine the patterns of direct medical costs of cancer care associated with seven major cancer types and estimate cost thresholds to distinguish each phase based on the incurred cost. Methods: In this nationwide, population-based study, we used claims data from the National Health Insurance Service, Korea. Patients newly diagnosed with cancer since 2006 and who died in 2016-2017 were enrolled, and their use of medical services during cancer survival from at least 6 months up to 12 years was observed. The monthly cost exhibited a non-linear function with two unknown thresholds resembling a U-shape; therefore, we fitted three linear segment models. Individual costs were assessed by dividing the survival time into the initial, continuing, and terminal phases by estimated thresholds, and the average medical cost for each phase was calculated. Results: Based on survival durations of 12 years or less, the initial phase occurred within 1.1-4.8 months after diagnosis, while the terminal phase was observed in 1.4-4.7 months before death. The length of these two phases increased with the increased survival time of the patients. Medical costs in these phases ranged from $4067-7431 and $3127-6114 (US dollars), respectively, regardless of the variations in survival time. However, the average costs in the continuing phase were higher for patients with a short survival time. Conclusions: This study highlights the cost dynamics in cancer care through a breakdown of the phases of survival. It suggests that through a more refined definition of the initial and terminal phases, the average cost in these stages increases, indicating the significant implications of the findings for resource allocation and tailored financial support strategies for patients with cancer with varying prognoses.
Collapse
Affiliation(s)
- Tae Mi Youk
- Research Institute, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
- Department of Statistics, Korea University, Seoul, Republic of Korea
| | - Jung Hwa Hong
- Research Institute, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Byung Kyu Park
- Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Young Min Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
3
|
Shimamoto T, Tateyama Y, Kobayashi D, Yamamoto K, Takahashi Y, Ueshima H, Sasaki K, Nakayama T, Iwami T. Survival and medical costs of non-small cell lung cancer patients according to the first-line treatment: An observational study using the Kyoto City Integrated Database. Thorac Cancer 2023. [PMID: 37082875 DOI: 10.1111/1759-7714.14900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Lung cancer is the primary cause of cancer mortality and non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases. New drug treatments have been developed since 2010 but there are concerns about the increase in medical costs. This study aimed to compare survival and medical costs among patients with NSCLC according to their initial treatment to estimate the impact of early NSCLC detection. METHODS Patients with primary NSCLC who filed insurance claims between April 2013 and March 2019 were identified using the Kyoto City Integrated Database. Patients were divided into two groups depending on their initial treatment: the resection group and drug or radiation group. The survival and medical costs were calculated. RESULTS A total of 2609 patients with primary NSCLC were identified. Among them, 1035 patients underwent resection. The 5-year survival was 75% for the resection group while below 25% for the drug or radiation group. At 6 months of survival, the median cumulative total cost was 2409 thousand yen (interquartile range [IQR] 1947-4012 thousand yen) in the resection group and 2951 thousand yen (IQR 1600-4706 thousand yen) in the drug or radiation group. At 4 years of survival, the cumulative median total cost was 5257 thousand yen (IQR 3808-8243 thousand yen) in the resection group and 10 202 thousand yen (IQR 4845-20 450 thousand yen) in the drug or radiation group. CONCLUSIONS As a first-line therapy in newly diagnosed patients with NSCLC, surgical resection is associated with longer survival and lower medical costs than pharmacotherapy or radiotherapy.
Collapse
Affiliation(s)
- Tomonari Shimamoto
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Yukiko Tateyama
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Daisuke Kobayashi
- Agency for Health, Safety and Environment, Kyoto University, Kyoto, Japan
| | - Keiichi Yamamoto
- Translational Research Institute for Medical Innovation, Osaka Dental University, Osaka, Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Hiroaki Ueshima
- Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
| | - Kosuke Sasaki
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Taku Iwami
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| |
Collapse
|
4
|
Cicin I, Oksuz E, Karadurmus N, Malhan S, Gumus M, Yilmaz U, Cansever L, Cinarka H, Cetinkaya E, Kiyik M, Ozet A. Economic burden of lung cancer in Turkey: a cost of illness study from payer perspective. HEALTH ECONOMICS REVIEW 2021; 11:22. [PMID: 34173876 PMCID: PMC8233643 DOI: 10.1186/s13561-021-00322-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/11/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND This study was designed to estimate economic burden of lung cancer in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. METHODS In this cost of illness study, direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations/interventions, drug treatment, adverse events and metastasis. Indirect cost was calculated based on lost productivity due to early retirement, morbidity and premature death resulting from the illness, the value of lost productivity due to time spent by family caregivers and cost of formal caregivers. RESULTS Cost analysis revealed the total per patient annual direct medical cost for small cell lung cancer to be €8772), for non-small-cell lung cancer to be €10,167. Total annual direct medical cost was €497.9 million, total annual indirect medical cost was €1.1 billion and total economic burden of lung cancer was €1.6 billion. Hospitalization/interventions (41%) and indirect costs (68.6%) were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. CONCLUSIONS Our findings indicate per patient direct medical costs of small cell lung cancer and non-small-cell lung cancer to be substantial and comparable, indicating the substantial economic burden of lung cancer in terms of both direct and indirect costs. Our findings indicate that hospitalization/interventions cost item and indirect costs were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Our findings emphasize the potential role of improved cancer prevention and early diagnosis strategies, by enabling cost savings related to drug treatment and metastasis management cost items, in sustainability of cancer treatments.
Collapse
Affiliation(s)
- Irfan Cicin
- Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ergun Oksuz
- Department of Family Medicine, Faculty of Medicine, Baskent University, Baglica Kampusu 06770, Etimesgut, Ankara, Turkey
| | | | - Simten Malhan
- Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Mahmut Gumus
- Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ulku Yilmaz
- University of Health Sciences, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Levent Cansever
- Yedikule Chest Disease and Thoracic Surgery Health Application and Research Center, University Of Health Sciences, Istanbul, Turkey
| | - Halit Cinarka
- Yedikule Chest Disease and Thoracic Surgery Health Application and Research Center, University Of Health Sciences, Istanbul, Turkey
| | - Erdogan Cetinkaya
- Yedikule Chest Disease and Thoracic Surgery Health Application and Research Center, University Of Health Sciences, Istanbul, Turkey
| | - Murat Kiyik
- Yedikule Chest Disease and Thoracic Surgery Health Application and Research Center, University Of Health Sciences, Istanbul, Turkey
| | - Ahmet Ozet
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|