Vol 63, No 3 (2013)
Research paper (original)
Published online: 2013-07-16
Breast cancer treatment expenditures in Poland
DOI: 10.5603/NJO.2013.0002
Nowotwory. Journal of Oncology 2013;63(3):217-226.
Abstract
Introduction. Breast cancer is one of the major problems of cancer, althought it is increasingly a treatable disease.
The fi ght against breast cancer should have an appropriate infrastructure and provide a clinically eff ective and cost
eff ective method of treatment. In this case, the knowledge on expenditures is essential (from the perspective of the
payer) and also costs of treatment (in terms of contractor services), so that decisions about expenditures on treating
breast cancer have been burdened with the least possible risk. Whereas treatment decisions should be based on
clinical evidence (evidence-based medicine), management should be based on evidence of an economic nature
(evidence-based management). The current analysis contributes to the discussion on proper fi nancial management
in the treatment of breast cancer.
Materials and methods. This analysis was based on the National Health Fund (NHF) data, available in the Register
of Diseases’ Treatment system. We analyzed data on about 104,000 patients treated in Poland for breast cancer in the years 2004–2010. That is, on all the patients identifi ed as “confi rmed” in the NHF system during this period. The
entire expenditure on therapy of particular patients have been counted, including expenditure from the beginning
of therapy to cure (or death). This analysis includes only NHF expenditure (the direct costs), and does not include
costs incurred by patients.
Results. Expenditure related to breast cancer treatment increased between 2004 and 2010 at a rate exceeding the
rate of consumer infl ation, and in 2010 reached about 500 million PLN. In 2010 expenditure per person averaged
32 thousand PLN, with signifi cant diff erences between individual regions. Expenditure per capita decreased strongly
with age — from about 67 thousand PLN in patients aged 30 years, to about 20 thousand PLN in those over 80 years
old. Expenditure on people who have undergone a screening mammography were about 8–15% lower than in other
patients.
Conclusions. Our data illustrate the scale of the fi nancial burden of treatment of breast cancer in Poland. Using
data accumulated in the NHF it is possible to calculate the total expenditure, and to demonstrate the diff erences in
spending between groups of patients diff ering in place of residence, age, date of commencement of treatment, or
participation in screening. These data allow for more informed and safe designing of changes and modifi cations in
the system of breast cancer management.
The fi ght against breast cancer should have an appropriate infrastructure and provide a clinically eff ective and cost
eff ective method of treatment. In this case, the knowledge on expenditures is essential (from the perspective of the
payer) and also costs of treatment (in terms of contractor services), so that decisions about expenditures on treating
breast cancer have been burdened with the least possible risk. Whereas treatment decisions should be based on
clinical evidence (evidence-based medicine), management should be based on evidence of an economic nature
(evidence-based management). The current analysis contributes to the discussion on proper fi nancial management
in the treatment of breast cancer.
Materials and methods. This analysis was based on the National Health Fund (NHF) data, available in the Register
of Diseases’ Treatment system. We analyzed data on about 104,000 patients treated in Poland for breast cancer in the years 2004–2010. That is, on all the patients identifi ed as “confi rmed” in the NHF system during this period. The
entire expenditure on therapy of particular patients have been counted, including expenditure from the beginning
of therapy to cure (or death). This analysis includes only NHF expenditure (the direct costs), and does not include
costs incurred by patients.
Results. Expenditure related to breast cancer treatment increased between 2004 and 2010 at a rate exceeding the
rate of consumer infl ation, and in 2010 reached about 500 million PLN. In 2010 expenditure per person averaged
32 thousand PLN, with signifi cant diff erences between individual regions. Expenditure per capita decreased strongly
with age — from about 67 thousand PLN in patients aged 30 years, to about 20 thousand PLN in those over 80 years
old. Expenditure on people who have undergone a screening mammography were about 8–15% lower than in other
patients.
Conclusions. Our data illustrate the scale of the fi nancial burden of treatment of breast cancer in Poland. Using
data accumulated in the NHF it is possible to calculate the total expenditure, and to demonstrate the diff erences in
spending between groups of patients diff ering in place of residence, age, date of commencement of treatment, or
participation in screening. These data allow for more informed and safe designing of changes and modifi cations in
the system of breast cancer management.