Abstract
ObjectiveTo assess the economic burden of epithelial ovarian cancer (EOC) in incident patients and the burden by disease stage in Spain.MethodsWe developed a Markov model from a social perspective simulating the natural history of EOC and its four stages, with a 10-year time horizon, 3-week cycles, 3% discount rate, and 2016 euros. Healthcare resource utilization and costs were estimated by disease stage. Direct healthcare costs (DHC) included early screening, genetic counselling, medical visits, diagnostic tests, surgery, chemotherapy, hospitalizations, emergency services, and palliative care. Direct non-healthcare costs (DNHC) included formal and informal care. Indirect costs (IC) included labour productivity losses due to temporary and permanent leaves, and premature death. Epidemiology data and resource use were taken from the literature and validated for Spain by the OvarCost group using a Delphi method.ResultsThe total burden of EOC over 10 years was 3102 mill euros: 15.1% in stage I, 3.9% in stage II, 41.0% in stage III, and 40.2% in stage IV. Annual average cost/patient was €24,111 and it was €8,641; €14,184; €33,858, and €42,547 in stages I–IV, respectively. Of total costs, 71.2% were due to DHC, 24.7% to DNHC, and 4.1% to IC.ConclusionsEOC imposes a significant economic burden on the national healthcare system and society in Spain. Investment in better early diagnosis techniques might increase survival and patients’ quality of life. This would likely reduce costs derived from late stages, consequently leading to a substantial reduction of the economic burden associated with EOC.
Highlights
Ovarian cancer (OC) is a rare disease but with a high mortality rate in women [1]
A Markov model was considered as the most appropriate method to simulate the progression of epithelial ovarian cancer (EOC), regarding the modelling approaches adopted in the previous economic studies and the nature of the disease [18, 19]
Labour productivity losses amounted to. This is the first study that is close to estimating the economic impact of EOC in Spain considering Direct healthcare costs (DHC) as well as Direct non-healthcare costs (DNHC) and Indirect costs (IC) involved in patient care
Summary
Ovarian cancer (OC) is a rare disease but with a high mortality rate in women [1]. In 2012, the estimated number of new cases in Europe was 65,538 and accounted for a total of 42,716 deaths [2]. EOC has a major impact on patients’ quality of life and implies an important economic burden for healthcare services, patients, and society in general, for several reasons These patients are treated with a large and growing amount of healthcare resources such as hospitalizations, medical appointments, and chemotherapy treatments administrated in day hospital units, since they are diagnosed [10, 11]. Despite the considerable costs described above, the economic burden of EOC from a societal perspective had been scarcely analysed in the international literature and, in Spain Measuring this burden may be relevant for healthcare decision makers, as it provides useful information to assess the real magnitude of the benefits derived from the possible intervention programs and health strategies targeting the disease. The secondary objective was to raise awareness about the importance of this cancer among society and healthcare authorities
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