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Oral cancer treatment costs in Greece and the effect of advanced disease.

Zavras A, Andreopoulos N, Katsikeris N, Zavras D, Cartsos V, Vamvakidis A - BMC Public Health (2002)

Bottom Line: Another aim was to identify factors that affect costs and potential cost reduction items.Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05).Disease stage was also associated with the total duration of hospitalization (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Policy & Epidemiology,Harvard School of Dental Medicine, 118 Longwood Avenue, Boston, MA 02115, USA. zavras@hms.harvard.edu

ABSTRACT

Background: The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs.

Methods: The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values.

Results: The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05).

Conclusions: The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.

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Cost of OC treatment (US$), stratified by stage of disease
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Figure 1: Cost of OC treatment (US$), stratified by stage of disease

Mentions: Costs were calculated by multiplying in-patient hospitalization and clinical procedures with a fair and customary fee and by adding expense items such as operating room charges, physician charges, radiation therapy and chemotherapy costs. Prices were sought in official publications or professional association catalogues. For example, prices for the chemotherapeutic medications were found in Pharmacopoeia. Medication prices are set by the Ministry of Trade and enforced by EOF, the National Organization for Pharmaceuticals (the FDA or EMEA analogue in Greece). Where no price was readily available or referenced in professional association publications, we obtained current data by calculating the mean value from three quotes obtained by 3 private hospitals. The exact cost categories and price values are presented in Figure 1.


Oral cancer treatment costs in Greece and the effect of advanced disease.

Zavras A, Andreopoulos N, Katsikeris N, Zavras D, Cartsos V, Vamvakidis A - BMC Public Health (2002)

Cost of OC treatment (US$), stratified by stage of disease
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC117788&req=5

Figure 1: Cost of OC treatment (US$), stratified by stage of disease
Mentions: Costs were calculated by multiplying in-patient hospitalization and clinical procedures with a fair and customary fee and by adding expense items such as operating room charges, physician charges, radiation therapy and chemotherapy costs. Prices were sought in official publications or professional association catalogues. For example, prices for the chemotherapeutic medications were found in Pharmacopoeia. Medication prices are set by the Ministry of Trade and enforced by EOF, the National Organization for Pharmaceuticals (the FDA or EMEA analogue in Greece). Where no price was readily available or referenced in professional association publications, we obtained current data by calculating the mean value from three quotes obtained by 3 private hospitals. The exact cost categories and price values are presented in Figure 1.

Bottom Line: Another aim was to identify factors that affect costs and potential cost reduction items.Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05).Disease stage was also associated with the total duration of hospitalization (p < 0.05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Policy & Epidemiology,Harvard School of Dental Medicine, 118 Longwood Avenue, Boston, MA 02115, USA. zavras@hms.harvard.edu

ABSTRACT

Background: The main purpose of the study was to quantify the direct costs of oral cancer treatment to the healthcare system of Greece. Another aim was to identify factors that affect costs and potential cost reduction items. More specifically, we examined the relationship between stage of disease, modality of treatment and total direct costs.

Methods: The medical records and clinic files of the Oral and Maxillofacial Clinic of the Athens General Hospital "Genimatas" were abstracted to investigate clinical treatment characteristics, including length of hospitalization, modes of treatment, stage of disease etc. Records of 95 patients with oral squamous cell carcinoma (OSSC), with at least six months of follow-up, were examined. The clinical data was then used to calculate actual direct costs, based on 2001 market values.

Results: The mean total direct costs for OSSC treatment estimated at euro 8,450 or approximately US$ 7,450. Costs depended on the stage of the disease, with significant increases in stages III and IV, as compared with stages I and II (p < 0.05). Multi-modality treatment applied mainly to patients in stages III and IV was the factor that affected the cost. Disease stage was also associated with the total duration of hospitalization (p < 0.05).

Conclusions: The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.

Show MeSH
Related in: MedlinePlus