The development of the cost of cancer in 31 European countries.

Abstract

1596 Background: The estimated number of new cancer cases in Europe has risen from 2.6 million in 1995 to 4.1 million in 2022. Around every fourth death is due to cancer, yet survival rates have been improving due to advances in early detection, diagnosis, and treatment. The implications of these epidemiological changes and medical advances for the overall cost of cancer are not well documented. Methods: This cost-of-illness study estimated the direct and indirect costs of cancer across 31 European countries (the EU-27 countries, plus Iceland, Norway, Switzerland, and the UK) from 1995 to 2023. For direct costs, information on cancer-specific health expenditure was searched for all countries and combined with data from Eurostat and the OECD. Extrapolations were made for countries with missing information. For indirect costs, productivity losses due to premature mortality were calculated using mortality data from the World Health Organization, Eurostat, and the Office for National Statistics, combined with labor market data from Eurostat. Productivity loss due to morbidity were estimated using data from prior studies and changes in population structure. The human-capital approach was employed to calculate indirect costs. Total costs, costs per capita, and costs per new case were estimated for Europe as a whole and for each individual country. Results: Between 1995 and 2023, the combined direct and indirect costs of cancer across all countries increased by 43% from EUR 159 billion to EUR 228 billion (all figures adjusted to 2023 prices). Direct costs grew by 135%, from EUR 62 to EUR 146 billion, while indirect costs, which fell below direct costs after 2005, decreased by 16% from EUR 97 to EUR 82 billion. The decline in indirect costs reflects a reduction in potential years of working life lost due to premature mortality of working-age patients. Direct costs of cancer accounted for 4-8% of total health expenditures in all countries, with modest increases over time in some but not all countries. Per capita costs for all countries combined rose by 35% from EUR 313 to 423. However, there was a seven-fold difference between countries in 2023 ranging from around EUR 150 in Bulgaria and Romania to EUR 1,011 in Switzerland. This disparity represents a reduction from the twelve-fold difference observed in 1995. The cost per new cancer case remained relatively stable in Europe as whole at around EUR 78,000 between 1995 and 2010, before declining slightly to EUR 72,000 in 2015 and stabilizing thereafter. Conclusions: The societal cost of cancer in Europe has been steadily increasing. The growing number of cancer patients is spurring this development, rather than changes in cost per patient, which has remained mostly stable for nearly 30 years. Although the direct costs of cancer have risen the most, this has been partially offset by reductions in indirect costs. Changes in indirect costs and epidemiological trends should be considered in debates about the rising costs of cancer.