Abstract 608P
Background
This cost-of-illness study analyses the socio-economic burden of endometrial, ovarian, cervical, and vaginal cancer survivorship for the ten years following initial treatment in Germany in 2000, 2010, and 2020.
Methods
We developed a patient-level micro-costing approach that considers direct and indirect medical expenses resulting from cancer follow-ups to estimate the economic spending on gynecological cancer survivorship. The frequency of recommended follow-up procedures was obtained from German guidelines. Direct medical expenses were derived from literature and official scales of tariffs, whilst indirect expenses were estimated based on opportunity costs. Follow-up-related costs were estimated in a cohort of 1,000 patients. Expenditure arising for patients, healthcare providers (including physicians and nurses), and insurers were combined to calculate societal costs.
Results
Mean ten-year follow-up costs for the society amounted to 6,388€ (95% CI: 5,256-7,387) for endometrial, 11,150€ (95% CI: 9,102-13,390) for ovarian, 11,440€ (95%CI: 9,080-13,390) for cervical, and 11,614€ (95% CI: 9,523-13,649) for vaginal cancer survivors in 2020. Societal expenditure rose by +24% from 2000 to 2020 (p<0.001). However, this increased economic burden was shifted towards patients and providers, as insurers only covered 33% of follow-up expenditure in 2000, compared to a reimbursement rate of 24% in 2020. Resources were consumed by physician-patient consultations and examinations (71%), diagnostic imaging (13%), and travel expenditure (16%). Expenses predominantly arose during earlier follow-up periods with more frequent and resource-intensive visits (years 1-2: 46%, years 3-5: 43%, years 6-10: 12%).
Conclusions
Advances in screening, diagnostics, and novel therapeutics successfully decreased cancer mortality rates; yet also led to a surge in the population of cancer survivors. This study highlights the rising socio-economic burden gynaecological cancer survivorship poses for patients and the healthcare system. The introduction of structured disease management programs should be explored to facilitate survivorship care.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.