PMID- 19944035
OWN - NLM
STAT- MEDLINE
DCOM- 20100303
LR  - 20091130
IS  - 1646-0758 (Electronic)
IS  - 0870-399X (Linking)
VI  - 22
IP  - 5
DP  - 2009 Sep-Oct
TI  - [Cost of cancer care in Portugal].
PG  - 525-36
AB  - INTRODUCTION: Cancer is the second most important cause of death in Portugal, 
      following cardiovascular diseases (CVD), and shows a constant progressive 
      increase in the proportional share of total deaths. In Portugal, as in most 
      countries, the health care budget is under constant cost-containment pressures. 
      In this context it is necessary to verify if enough resources have been allocated 
      to the disease in terms of health care expenditure. The main objective of this 
      study is to estimate the cost of cancer care in Portugal and to compare it to 
      similar data in Europe and the United States of America (USA), to the cost of 
      CVD. The secondary objective is to evaluate the cost of pharmaceuticals used in 
      the treatment of cancer in Portugal, both in relation to total pharmaceutical 
      expenditure and to other therapeutic areas. METHODS: Three main sources of 
      information were used: comprehensive literature review, primary and secondary 
      data sources, and a modified Delphi Panel, which was used to fill in gaps in the 
      information derived from the data sources and the literatura review. The burden 
      of cancer was measured through the Disability-adjusted life-year (DALY) and, in 
      order to determine the costs of cancer, detailed information on the costs of 
      medical visits and of inpatient episodes based on Diagnosis Related Groups (DRG), 
      in 2006, was used. To estimate the total cost of cancer, we used a combination of 
      top down (breaking global expenditure data to specific levels) and bottom up 
      methodology (based on the sum of different components). RESULTS: Based on 2006 
      data on direct medical care expenditures in Portugal, we found that 565 million 
      euro were spent on cancer in comparison to 1 320 million on CVD representing 
      3.91% and 9.14% of total cost on health respectively. When we break down total 
      expenditure on drugs by therapeutic area we find that CVD drugs represent about 
      21.6% of total drug costs in Portugal and cancer drugs represent about 5.6% of 
      the total. Oncology drugs represent 32% of the total expenditure on cancer, while 
      CVD drugs represent 54% of the total expenditure on CVD. In comparison, in terms 
      of BoD in Portugal, 18.6% of DALY's were associated with CVD and 15.3% with 
      cancer. CONCLUSION: Considering the burden of disease (BoD) of CVD and cancer in 
      Portugal, we can state that the expenditure allocated to cancer is significantly 
      lower than expected. Using the criterion of expenditure according to need, we 
      observed that there is an imbalance of expense/BoD in oncology indicating that 
      cancer seems to be underfunded in Portugal. Even considering that this shouldn't 
      be the only criterion to determine the volume of expense in a certain therapeutic 
      area, the differential observed in this study is sufficiently high to deserve 
      attention from the decision-makers.
FAU - Araujo, Antonio
AU  - Araujo A
AD  - Servico de Oncologia. Instituto Portugues de Oncologia. Porto.
FAU - Barata, Fernando
AU  - Barata F
FAU - Barroso, Sergio
AU  - Barroso S
FAU - Cortes, Paulo
AU  - Cortes P
FAU - Damasceno, Margarida
AU  - Damasceno M
FAU - Parreira, Antonio
AU  - Parreira A
FAU - Espirito Santo, Jorge
AU  - Espirito Santo J
FAU - Teixeira, Encarnacao
AU  - Teixeira E
FAU - Pereira, Ricardo
AU  - Pereira R
LA  - por
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
TT  - Custo do tratamento do cancro em Portugal.
DEP - 20091022
PL  - Portugal
TA  - Acta Med Port
JT  - Acta medica portuguesa
JID - 7906803
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiovascular Diseases/economics/therapy
MH  - Child
MH  - Child, Preschool
MH  - Cost of Illness
MH  - Europe
MH  - Humans
MH  - Infant
MH  - Middle Aged
MH  - Neoplasms/*economics/*therapy
MH  - Portugal
MH  - United States
MH  - Young Adult
EDAT- 2009/12/01 06:00
MHDA- 2010/03/04 06:00
CRDT- 2009/12/01 06:00
PHST- 2009/05/05 00:00 [received]
PHST- 2009/08/18 00:00 [accepted]
PHST- 2009/12/01 06:00 [entrez]
PHST- 2009/12/01 06:00 [pubmed]
PHST- 2010/03/04 06:00 [medline]
PST - ppublish
SO  - Acta Med Port. 2009 Sep-Oct;22(5):525-36. Epub 2009 Oct 22.