TY - JOUR
T1 - The lifetime cost of hepatocellular carcinoma
T2 - A claims data analysis from a medical centre in Taiwan
AU - Lang, Hui Chu
AU - Wu, Jaw Ching
AU - Yen, Sang Hue
AU - Lan, Chung Fu
AU - Wu, Shi Liang
N1 - Funding Information:
This study was funded by Taiwan National Health Research Institutes (NHRI-EX94-9007PC). The authors would like to thank Wei-Lun Chen, Wei-Yi Huang, Yi-Lin Ko, Cheng-Yun Pu for the data management and SAS (SAS Institute Inc., Cary, NY, USA) programming.
PY - 2008
Y1 - 2008
N2 - Background: Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. Objective: To determine cancer-related medical care costs for long-term survivors of HCC. Methods: The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. Results: The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US1 = $NT33, year 2002 value) over this period. For those who survived ≥1 year, the terminal phase of treatment resulted in the highest costs, $NT237 032. On average, for each patient, the initial phase cost was $NT140 403 and the monthly cost for the continuing phase was $NT8687. For the average HCC patient, the 10-year lifetime cost was $NT418 554 (in nominal $NT). Conclusion: Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.
AB - Background: Hepatocellular carcinoma (HCC) is the second most common cancer in Taiwan. For males in Taiwan, it is the most dangerous cancer, with both the highest incidence and mortality rate. Objective: To determine cancer-related medical care costs for long-term survivors of HCC. Methods: The estimation of the lifetime cost was based on the insurer perspective and adopted an incidence-based approach. Data was sourced from the 1999-2002 cancer registry statistics of patients with HCC and the claims data of Taipei Veterans General Hospital (TVGH). In total there were 2873 HCC patients at TVGH. In addition to this data, the research used population National Health Insurance claims data from the National Health Research Institutes (1996-2002) as the comparison group. The probabilities of survival, dying of cancer or dying of other causes were estimated using cancer registry statistics. To estimate lifetime (10-year) cost, we divided the disease process into three phases: initial, continuing and terminal. The cost of HCC was calculated as the sum of the average cost of each phase. The expected lifetime cost for treatment of an HCC patient was estimated by incorporating the phase-specific costs with the survival and mortality rates. Results: The results showed that 895 patients survived <1 year, and treatment for each of these patients cost on average New Taiwan dollars ($NT) 206 573 ($US1 = $NT33, year 2002 value) over this period. For those who survived ≥1 year, the terminal phase of treatment resulted in the highest costs, $NT237 032. On average, for each patient, the initial phase cost was $NT140 403 and the monthly cost for the continuing phase was $NT8687. For the average HCC patient, the 10-year lifetime cost was $NT418 554 (in nominal $NT). Conclusion: Our study showed that the terminal phase cost the most out of the three treatment phases. The aggregate lifetime cost of HCC is useful for health policy making and clinical decision making.
KW - Cost of illness
KW - Liver cancer
UR - http://www.scopus.com/inward/record.url?scp=51849117371&partnerID=8YFLogxK
U2 - 10.2165/00148365-200806010-00005
DO - 10.2165/00148365-200806010-00005
M3 - Article
C2 - 18774870
AN - SCOPUS:51849117371
SN - 1175-5652
VL - 6
SP - 55
EP - 65
JO - Applied Health Economics and Health Policy
JF - Applied Health Economics and Health Policy
IS - 1
ER -
