New research shows huge costs of colorectal cancer to patients and health systems
Colorectal cancer is the second leading cause of cancer death in Europe, with one European dying of colorectal cancer every three minutes. In the UK, over 16,000 people die of this common disease every year.
This new research, led by DATA-CAN’s founding partner Queen’s University Belfast, demonstrates the tremendous economic burden that colorectal cancer places on health systems, patients and their families, and highlights the significant inequalities that European colorectal cancer patients experience, depending on where they live.
The study also highlights how a higher spend on cancer drugs than on hospital care, did not always lead to better patient outcomes.
The research, published in high impact journal Lancet Gastroenterology and Hepatology, found the economic cost of colorectal cancer in Europe to be €19.1 billion (£16.3 billion) and €2.01 billion (£1.7 billion) in the UK.
This figure breaks down into direct expenditure on colorectal cancer care in Europe to €7.5 billion (£6.4 billion), just under 40 per cent of the total cost. In the UK the figure is €361 million (£307.8 million), at 18 per cent of total cost. The indirect economic impact, which measures the costs of premature death, temporary and permanent absence from work, and unpaid informal care, was €11.6 billion (£9.9 billion), over 60 per cent of the total cost. In the UK the figure is €1.65 billion (£1.4 billion), at 82 per cent of total cost.
Senior author on the paper, Professor Mark Lawler, Associate Pro-Vice Chancellor and Professor of Digital Health at Queen’s University Belfast and Scientific Director of DATA-CAN, the UK’s Health Data Research Hub for Cancer, said,
“Our research highlights the enormous impact that colorectal cancer has, not only on the health of our citizens, but also increasingly on the financial prosperity of patients, their families, health systems and economies. By not investing appropriately in services such as screening, early diagnosis and treatment, we have created an economic time bomb that is placing an untenable burden on our health systems and on society.”
The research also found a wide variation in the economic burden of colorectal cancer across Europe. Countries with similar gross domestic product (GDP) per head of population had widely varying health-care expenditures on colorectal cancer, leading to significant inequalities for colorectal cancer patients, depending on where they live in Europe.
Expenditure on cancer drugs was found to have increased by over 200 per cent on average over a six-year period but was not necessarily associated with better outcomes. This was particularly the case in Eastern Europe where in countries such as Bulgaria (+818 per cent) and Hungary (+398 per cent), expenditure on cancer drugs was higher than hospital care costs (unlike the EU average) but was associated with poorer outcomes.
“It’s not what you spend, it’s the way that you spend it” said Professor Lawler. “We must ensure that we use our precious healthcare resources in a way that ensures better outcomes for patients but delivered with cognisance of the financial pressures that health systems currently face, particularly in the context of Covid.”
The UK was one of several countries in the EUR-33 to spend significantly more on cancer drugs (€151 million (£128.8 million); 42 per cent of total costs) than on hospital care (€117 million (£99.8 million); 32 per cent of total costs), but this did not correlate with improved outcomes for patients.
Several central and western European countries also had significantly increased spend on cancer drugs (notably Ireland (+473 per cent) and Austria (+369 per cent)), mostly due to increases in the use of targeted cancer drugs. In the UK, spend on cancer drugs went up by 352 per cent, from €33 million to €151 million (£28.1 million to £128.8 million).
Professor Richard Sullivan, Director of the Institute of Cancer Policy at Kings College London and co-author on the paper, said: “This paper is the most comprehensive to date on the economic burden of colorectal cancer across Europe. Our results have major implications for guiding policy and improving outcomes for this common malignancy.”
For this study, Europe refers to the EUR 33, the 27 members of the EU and Iceland, Norway, Serbia, Switzerland, Turkey, and the UK.
Co-authors of the study are represented by the following institutions: Patrick G Johnston Centre for Cancer Research and Queen’s Management School, Queen’s University Belfast; MRC Oxford Institute for Radiation Oncology, University of Oxford; Centre for Trials Research, Cardiff University; Cancer Survival Group, London School of Hygiene and Tropical Medicine; Institute of Cancer Policy, King’s College London; King’s Health Partners Comprehensive Cancer Centre.
Funding for this work came through grants from the Department for Employment and Learning of Northern Ireland, the Medical Research Council, Cancer Research UK, Cancer Focus Northern Ireland, Health Data Research UK (HDR UK), and through HDR UK funding to DATA-CAN.
By not investing appropriately in services such as screening, early diagnosis and treatment, we have created an economic time bomb that is placing an untenable burden on our health systems and on society.