Abstract
BackgroundEsophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends.MethodsFrom 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan (CNY; 1 CNY = 0.155 USD) based on the 2011 value and inflated using the year-specific health care consumer price index for China.ResultsA total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002 (25,111 CNY) to 2011 (46,124 CNY). The average expenditures were 34,460 CNY for stage I, 39,302 CNY for stage II, 40,353 CNY for stage III, and 37,432 CNY for stage IV diseases (P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy (P < 0.05). Drugs contributed to 45.02% of the overall expenditure.ConclusionsThese conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.
Highlights
Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions
Characteristics of included esophageal cancer cases A total of 14,967 esophageal cancer patients, with an average diagnosis age of 60.93 ± 9.90 years, were included in the analysis (Table 2)
47.12% were from the eastern region of China, 77.08% were from specialized hospitals, and 91.88% were from 3A hospitals
Summary
Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. Esophageal cancer is the eighth most common cancer worldwide with estimates of 455,784 new cases and 400,156 deaths in 2012 [1]. China had the highest number of new esophageal cancer cases (more than 223,000) worldwide in 2012 [2]. The number of new esophageal cancer cases in China will increase to 433,783 by the year 2035 [1]. As the survival for esophageal cancer patients is prolonging and the average cost of esophageal cancer treatments is increasing, the economic burden of patients has continued to grow. The need for prevention strategies is urgent, and the implementation of effective measures should be based on evidence from health economic analyses
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