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Li F, Chen Y, Xiao D, Jiang S, Yang Y. Cost-Effectiveness Analysis of Sintilimab Plus Chemotherapy in Advanced Non-Squamous Non-Small Cell Lung Cancer: A Societal Perspective. Adv Ther 2024; 41:1436-1449. [PMID: 38356107 DOI: 10.1007/s12325-024-02808-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION The updated ORIENT-11 study demonstrated that sintilimab, when combined with chemotherapy, had promising survival advantage compared to standard chemotherapy alone in the first-line treatment for previously untreated, locally advanced or metastatic non-squamous non-small cell lung cancer (nsNSCLC). This study aims to evaluate the cost-effectiveness of sintilimab plus chemotherapy for advanced nsNSCLC from a Chinese societal perspective. METHODS A partitioned survival model with a embedded decision tree was developed to assess the economic value of sintilimab plus chemotherapy over a lifetime horizon. Clinical data was captured from the updated ORIENT-11 study, while costs, health productivity losses, and utility values were collected from a nationwide cross-sectional survey in tertiary hospitals across multiple provinces in China. The primary outcomes were measured using the metrics of quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Costs and health outcomes were discounted at an annual rate of 5% per annum. Sensitivity analyses, including one-way and probabilistic sensitivity analyses, subgroup analyses, and scenario analyses, were performed. RESULTS Compared to standard chemotherapy, treatment with sintilimab plus chemotherapy incurred a mean total cost of $23,979 and gained 0.98 QALYs over the lifetime horizon, resulting in an ICER of $24,568 per QALY gained. The use of sintilimab accumulated direct non-medical costs of $9262 and indirect costs of $6780 over 16 years. Probabilistic sensitivity analyses showed an 84.2% probability of sintilimab plus chemotherapy being cost-effective at a threshold of three times China's per capita gross domestic product in 2022 ($38,201). The model was most sensitive to the discount rate of QALYs and costs, as well as the costs of pemetrexed, sintilimab, and subsequent therapy in progressive disease state. Subgroup analyses indicated favorable incremental net monetary benefits in all subgroups. CONCLUSION Sintilimab plus chemotherapy is a cost-effective first-line treatment therapy for advanced nsNSCLC in China when compared to standard chemotherapy. These findings, along with the improved progression-free survival and overall survival (OS) observed in ORIENT-11, support the use of this regimen in eligible candidates for advanced nsNSCLC.
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Affiliation(s)
- Fuming Li
- School of Public Health, Fudan University, Shanghai, People's Republic of China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, People's Republic of China
| | - Yingyao Chen
- School of Public Health, Fudan University, Shanghai, People's Republic of China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, People's Republic of China
| | - Dunming Xiao
- School of Public Health, Fudan University, Shanghai, People's Republic of China
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, People's Republic of China
| | - Shan Jiang
- Macquarie University Centre for the Health Economy, Macquarie Business School and Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Yi Yang
- School of Public Health, Fudan University, Shanghai, People's Republic of China.
- National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, People's Republic of China.
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El Harch I, Guendaoui S, Charkaoui M, Benmaamar S, Omari M, El Youbi M, Belakhhel L, Abouselham L, Hachri H, El Menchay I, El Fakir S, Berraho M, Benchekroun N, Tachfouti N. Economic burden of lung cancer in Morocco: A cost of illness study. J Cancer Policy 2023; 37:100428. [PMID: 37353003 DOI: 10.1016/j.jcpo.2023.100428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/04/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION Lung cancer is the most common cancer in men and the second most common cancer in women. It is associated with substantial economic impact in terms of direct and indirect costs. The main objective of this study is to estimate the direct medical cost of lung cancer management in Morocco MATERIALS AND METHODS: A cost-of-illness study was conducted among patients treated at the Mohammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using a bottom-up approach. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by the national health insurance agency. The horizon time adopted was 12 months. RESULTS The study included 271 patients, with an average age of 62.5 ± 9.5 years. Of these, 93.4 % were men and 92.1 % were former smokers. In terms of cancer staging, 68.3 % of patients were in stage IV while 28.8 % were in stage III. Adenocarcinoma was present in 43.5 % of cases. Patients underwent an average of 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests, and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95 % CI: 4037.4-4873.2). Chemotherapy accounted for 19.9 % of the total cost, while radiological investigations and drugs accounted for 18.7 % and 17.6 %, respectively. Diagnostic tests and radiotherapy each accounted for 7.6 % of the total cost, while biological tests accounted for 7.5 % and hospitalizations accounted for 7.1 %. The cost was statistically higher in young patients (p = 0.017), in patients with adenocarcinoma (p < 0.0001), in patients with stage II tumor (< 0.00001), in patients who have undergone surgery (p = 0.002), chemotherapy (p < 0.0001), radiotherapy (p < 0.001) and in those without metastases (p < 0.0001). CONCLUSION These results provide evidence to support the ratification of the Framework Convention on Tobacco Control and the full adherence of the Kingdom of Morocco to the MPOWER measures.
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Affiliation(s)
- I El Harch
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco.
| | - S Guendaoui
- Moahammed VI Center for Cancer Care, Casablanca, Morocco
| | - M Charkaoui
- Moahammed VI Center for Cancer Care, Casablanca, Morocco
| | - S Benmaamar
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco
| | - M Omari
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco
| | - M El Youbi
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - L Belakhhel
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - L Abouselham
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - H Hachri
- World Health Oranization Country of Morocco, Morocco
| | - I El Menchay
- World Health Oranization Country of Morocco, Morocco
| | - S El Fakir
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco
| | - M Berraho
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco
| | - N Benchekroun
- Moahammed VI Center for Cancer Care, Casablanca, Morocco
| | - N Tachfouti
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco
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Fu R, Sun K, Wang X, Liu B, Wang T, Morze J, Nawrocki S, An L, Zhang S, Li L, Wang S, Chen R, Sun K, Han B, Lin H, Wang H, Liu D, Wang Y, Li Y, Zhang Q, Mu H, Geng Q, Sun F, Zhao H, Zhang X, Lu L, Mei D, Zeng H, Wei W. Survival differences between the USA and an urban population from China for all cancer types and 20 individual cancers: a population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100799. [PMID: 37693879 PMCID: PMC10485681 DOI: 10.1016/j.lanwpc.2023.100799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/13/2023] [Accepted: 05/07/2023] [Indexed: 09/12/2023]
Abstract
Background The systematic comparison of cancer survival between China and the USA is rare. Here we aimed to assess the magnitude of survival disparities and disentangle the impact of the stage at diagnosis between a Chinese metropolitan city and the USA on cancer survival. Methods We included 11,046 newly diagnosed cancer patients in Dalian Cancer Registry, China, 2015, with the follow-up data for vital status until December 2020. We estimated age-standardised 5-year relative survival and quantified the excess hazard ratio (EHR) of death using generalised linear models for all cancers and 20 individual cancers. We compared these estimates with 17 cancer registries' data from the USA, using the Surveillance, Epidemiology, and End Results database. We further estimated the stage-specific survival for five major cancers by region. Findings Age-standardised 5-year relative survival for all patients in Dalian was lower than that in the USA (49.9% vs 67.9%). By cancer types, twelve cancers with poorer prognosis were observed in Dalian compared to the USA, with the largest gap seen in prostate cancer (Dalian: 55.8% vs USA: 96.0%). However, Dalian had a better survival for lung cancer, cervical cancer, and bladder cancer. Dalian patients had a lower percentage of stage Ⅰ colorectal cancer (Dalian: 17.9% vs USA: 24.2%) and female breast cancer (Dalian: 40.9% vs USA: 48.9%). However, we observed better stage-specific survival among stage Ⅰ-Ⅱ lung cancer patients in Dalian than in the USA. Interpretation This study suggests that although the overall prognosis for patients was better in the USA than in Dalian, China, survival deficits existed in both countries. Improvement in cancer early detection and cancer care are needed in both countries. Funding National Key R&D Program (2021YFC2501900, 2022YFC3600805), Major State Basic Innovation Program of the Chinese Academy of Medical Sciences (2021-I2M-1-010, 2021-I2M-1-046), and Talent Incentive Program of Cancer Hospital of Chinese Academy of Medical Sciences.
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Affiliation(s)
- Ruiying Fu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Ke Sun
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Xiaofeng Wang
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Bingsheng Liu
- School of Public Policy and Administration, Chongqing University, No.174 Shazhengjie, Shapingba District, Chongqing, 400044, China
| | - Tao Wang
- School of Public Policy and Administration, Chongqing University, No.174 Shazhengjie, Shapingba District, Chongqing, 400044, China
| | - Jakub Morze
- College of Medical Sciences, SGMK University, Olsztyn, Poland
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Sergiusz Nawrocki
- Department of Oncology, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-228, Olsztyn, Poland
| | - Lan An
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Siwei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Li Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Shaoming Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Ru Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Kexin Sun
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Bingfeng Han
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hong Lin
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Huinan Wang
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Dan Liu
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Yang Wang
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Youwei Li
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Qian Zhang
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Huijuan Mu
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, China
| | - Qiushuo Geng
- School of Medical Device, Shenyang Pharmaceutical University, Benxi, 117004, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Haitao Zhao
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale Cancer Center, Yale University, New Haven, CT, 06520, USA
- Yale Cancer Center and Center for Biomedical Data Science, Yale University, 60 College Street, New Haven, CT, 06520, USA
| | - Dan Mei
- Dalian Center for Disease Control and Prevention, Liaoning, 116035, China
| | - Hongmei Zeng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Wenqiang Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
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Shang J, Zhou L, Huang L, Yang F, Liu Y, Zhang C, Zu L, Fan R, Zhang X, Liu Y, Feng Y. Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in nine major cities of China, 2016-2020: a retrospective observational study based on inpatient and outpatient hospital data. BMJ Open 2023; 13:e069645. [PMID: 36931677 PMCID: PMC10030656 DOI: 10.1136/bmjopen-2022-069645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVES It is unclear whether the use of antineoplastic drugs for patients with lung cancer in China has changed after the implementation of the national drug price negotiation in 2016 and continual update of clinical guidelines. This study aims to evaluate the trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in major cities of China. DESIGN We conducted a retrospective observational study using data from January 2016 to December 2020. SETTING This study used prescription records based on inpatient and outpatient hospital data from 97 hospitals in 9 major cities of China. PARTICIPANTS A total of 218 325 antineoplastic drug prescriptions in patients with lung cancer were retrospectively collected from the Hospital Prescription Analysis Cooperative Project during the study period. OUTCOME MEASURES Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer. RESULTS The yearly antineoplastic prescriptions increased by 85.6% from 28 594 in 2016 to 53 063 in 2020 (Z=1.71, p=0.086). Significant increases were seen in the prescriptions for protein kinase inhibitors (PKIs) and monoclonal antibodies (mAbs), whereas significant decreases were observed in antimetabolites, plant alkaloids and platinum compounds. The yearly cost increased progressively by 145.0% from ¥113.6 million in 2016 to ¥278.3 million in 2020 (Z=2.20, p=0.027). The top three anticancer drug classes in terms of total cost were PKIs, antimetabolites and mAbs. In prescribing patterns of antineoplastic agents for lung cancer, monotherapy, and triple or more drug combinations gradually increased, while dual combinations decreased significantly from 30.8% to 19.6%. CONCLUSIONS Prescription practices among patients with lung cancer in China underwent major changes during the study period. The observed trends can aid in understanding the present medication use status of patients with lung cancer in China and provide information for future drug management.
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Affiliation(s)
- Jingyuan Shang
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
- Faculty of Life Sciences and Biopharmaceuticals, Shenyang Pharmceutical University, Shenyang, China
| | - Lixin Zhou
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Lin Huang
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
| | - Feng Yang
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Yanguo Liu
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Chunyan Zhang
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
| | - Li'an Zu
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Rongrong Fan
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China
| | - Xiaohong Zhang
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
| | - Yi Liu
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
| | - Yufei Feng
- Department of Pharmacy, Peking University People's Hospital, Beijing, China
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Wang Y, Lei H, Li X, Zhou W, Wang G, Sun A, Wang Y, Wu Y, Peng B. Lung Cancer-Specific Mortality Risk and Public Health Insurance: A Prospective Cohort Study in Chongqing, Southwest China. Front Public Health 2022; 10:842844. [PMID: 35570974 PMCID: PMC9099244 DOI: 10.3389/fpubh.2022.842844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/06/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The incidence and mortality of lung cancer rank first among malignant tumors, and its long treatment cycle will bring serious economic burdens to lung cancer patients and their families. There are few studies on the prognosis of lung cancer and insurance policies. This article explores the relationship between the lung cancer-specific death and public health insurance, self-paying rate, and the joint effect of public health insurance and self-paying rate. Materials and Methods A prospective longitudinal cohort study was conducted in Chongqing, China from 2013 to 2019. The selected subjects were patients with C33–C34 coded according to the tenth edition of the International Classification of Diseases (ICD-10), aged 20 years or older. We conduct a subgroup analysis based on public health insurance types and self-paying rates. After following the inclusion and exclusion criteria, the chi-square test was used to describe the demographic and clinical characteristics of patients with different insurance types and different self-paying rates. Multivariate logistic regression was used to analyze the relationship between patients with different insurance types, self-paying rates, and lung cancer treatment methods. Finally, the Cox proportional hazard model and the competitive risk model are used to calculate the cumulative hazard ratio of all-cause death and lung cancer-specific death for different insurance types and different self-paying rate groups. Results A total of 12,464 patients with lung cancer were included in this study. During the follow-up period (median 13 months, interquartile range 5.6–25.2 months), 5,803 deaths were observed, of which 3,781 died of lung cancer. Compared with patients who received urban resident-based basic medical insurance (URBMI), patients who received urban employee-based basic medical insurance (UEBMI) had a 38.1% higher risk of lung cancer-specific death (Hazard Ratios (HRs) = 1.381, 95% confidence interval (CI): 1.293–1.476, P < 0.005), Compared with patients with insufficient self-paying rate, patients with a higher self-paying rate had a 40.2% lower risk of lung cancer-specific death (HRs = 0.598, 95% CI: 0.557–0.643, P < 0.005). Every 10% increase in self-paying rate of URBMI reduces the risk of lung cancer-specific death by 17.6%, while every 10% increase in self-paying rate of UEBMI reduces the risk of lung cancer-specific death by 18.0%. Conclusions The National Medical Security Administration should, under the condition of limited medical insurance funds, try to include the original self-paid anti-tumor drugs into the national medical insurance coverage. This can not only reduce the mortality rate of lung cancer patients, but also reduce the family burden of lung cancer patients. On the other hand, high-risk groups should increase their awareness of lung cancer screening and actively participate in the national cancer screening project led by the state.
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Affiliation(s)
- Yuqi Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Haike Lei
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaosheng Li
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Wei Zhou
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Guixue Wang
- MOE Key Lab for Biorheological Science and Technology, State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering Chongqing University, Chongqing, China
| | - Anlong Sun
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Ying Wang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
- *Correspondence: Ying Wang
| | - Yongzhong Wu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
- Yongzhong Wu
| | - Bin Peng
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Bin Peng
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Catastrophic health expenditure and its determinants in households with lung cancer patients in China: a retrospective cohort study. BMC Cancer 2021; 21:1323. [PMID: 34893037 PMCID: PMC8665572 DOI: 10.1186/s12885-021-09030-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/17/2021] [Indexed: 12/28/2022] Open
Abstract
Background Numerous studies have examined catastrophic health expenditures (CHE) worldwide, mostly focusing on general or common chronic populations, rather than particularly vulnerable groups. This study assessed the medical expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China. Methods During 2018–2019, a hospital-based multicenter retrospective survey was conducted in seven provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. CHE was measured according to the proportion of out-of-pocket (OOP) health payments of households on non-food expenditures. Chi-square tests and logistic regression analysis was adjusted to determine the factors that significantly influenced the likelihood of a household with lung cancer patient to incur in CHE. Results In total, 470 households with lung cancer patients were included in the analysis. Health insurance was shown to protect some households from the impact of CHE. Nonetheless, CHE incidence (78.1%) and intensity (14.02% for average distance and 22.56% for relative distance) were still relatively high among households with lung cancer patients. The incidence was lower in households covered by the Urban Employee Basic Medical Insurance (UEMBI) insurance, with higher income level and shorter disease course. Conclusion More attention is needed for CHE incidence among vulnerable populations in China. Households with lung cancer patients were shown to be more likely to develop CHE. Therefore, policy makers should focus on improving the financial protection and reducing the economic burden of this disease.
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