ANALYSIS OF THE economic burden of cancer across the European Union shows that the disease cost the 27 nations €126 billion in just one year.

Using data from 2009, the most recent year for which there was comprehensive information, researchers found the healthcare costs were the equivalent of €102 per citizen.

But there was a wide variance across different countries. In Bulgaria, the spend was just €16 per person, while in Luxembourg it was €184 per person.

The study, published today in the Lancet Oncology journal, also divided the disease into categories. At €18.8 billion, lung cancer had the highest economic cost. It was followed closely by breast cancer at €15 billion and colorectal cancer at €13.1 billion. Prostate cancer accounted for €8.43 million, or 7 per cent, of the spend.

In 2008, 2.45 million people were diagnosed with cancer. In the same year, across the 27 countries, 1.23 million died.

The comprehensive cost analysis looked at expenditure on care in the primary, outpatient, emergency and inpatient settings, as well as drugs.

The authors – from the Health Economics Research Centre, at the Nuffield Department of Population Health, University of Oxford, UK, and from King’s College London, Institute of Cancer Policy and KHP Cancer Centre UK - also estimated the costs of unpaid care provided by friends and relatives, lost earnings from premature death and costs associated with those who left employment because of illness.

Productivity losses because of early death cost €42.6 billion and lost working days €9.43 billion. Altogether, friends and family of people with cancer were estimated to have provided 3 billion hours of unpaid care, valued at €23.2 billion, to patients.

Of the total figure of €126 billion, €51 billion was incurred by health systems with the rest falling on patients’ families, friends and society overall.

Despite the enormous figures, researchers warned that the estimates are “conservative” as they do not include some categories of healthcare costs such as screening programmes. These were not included as data could not be obtained for all countries being studied.

The authors of the study believe the analysis will be useful for policymakers so they can better allocate research funds and to deliver cancer services in a way that provides good value for money.

The same researchers – Dr Ramon Luengo-Fernandez, Jose Leal, Professor Alastair Gray and Professor Richard Sullivan – previously estimated the cost of cardiovascular disease on the EU and found the economic burden to be €195 billion.

However, the cost of productivity losses due to premature death was nearly twice as high for cancer as that for cardiovascular disease (€43 billion compared to €27 billion), reflecting the higher number of cancer-related deaths in people of working age.

“It is vital that decision-makers across Europe use this information to identify and prioritise key areas,” said Professor Sullivan from King’s College London.

More effective targeting of investment may prevent health care systems from reaching breaking point – a real danger given the increasing burden of cancer – and in some countries better allocation of funding could even improve survival rates.

The wide differences between countries, in terms of their spends on cancer, now require further investigation, say the researchers.

The data was collated from international health organisations (WHO and EUROSTAT), as well as national ministries of health and statistical institutes to estimate the total cost of cancer across the EU in 2009, the most recent year for which comprehensive data were available. The study was funded by Pfizer.

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