Morbidity and financing cancer therapies in Poland between the years 2002 and 2011 based on the National Health Fund data
Abstract
Introduction. Cancer related illnesses are a serious problem due to the always increasing number of such illnesses and the high cost of diagnosis and treatment. The increase in the ratio of elderly people together with the higher risk of exposure to harmful environmental factors and the development of diagnostic methods result in an increased number of diagnosed cancers. The aim of the work was to determine the population of the persons diagnosed with cancer in Poland, evaluate the tax payers’ expenses connected with anti-cancer treatment and evaluate costs related to the introduction of the state-of-the-art treatment methods of the ill diagnosed with cancers.
Material and methods. In order to carry out analyses of report information in the NHF data bases, an analytical module was created called the Illness Treatment Register (ITL). This enables downloading of information from the database and presenting it in real time. In the analysis, a method of evaluating the cost of introducing the innovation was assumed. Namely it was assumed that the cost of innovation is the value of funds expended by the public tax payers in a given year that remain, after extrapolation of therapy costs from the previous year per number of ill persons in a given year. The analysis did not consider the value of the inflation index. The PESEL number was considered to be the uniqueidentity number of the ill person. An excel calculation sheet was used in the data analysis which was carried out with the use of all items existing in the database, not differentiating the degree of credibility of diagnosis confirmation.
Results. The number of all the established persons diagnosed with cancer between the years 2002 and 2011 increased annually and reached over 1 million people in 2011 who were treated because of cancers. The average yearly dynamics of the patient numbers compare to the previous year, oscillated around +11%. Diagnosis that throughout the whole tested period exceeded 10% of the budget allocated for the oncological diagnoses, included breast cancer (C50) — 14.41% of the budget and exceeded the average annual cost for oncological diagnoses by nearly 1400%, and bronchi and lungs cancer (C34) — 10.5% of the budget and exceeded the average annual cost for oncological diagnoses by 1018%. Diagnosis with the highest annual average in the anaysed period were breast cancer (C50) — 566 944 649 PLN and bronchi and lungs cancer (C34) — 412 877 994 PLN. The above mentioned cancers were alsothe diagnoses of the highest number of health services between the years 2002 and 2011.
Conclusions. The analyses showed that from over 100 groups of diagnosed cancers, there are around 35 that arerelevant from the point of view of social epidemiology. This indicates that the National Cancer Prevention Programme should treat these illnesses with a high priority and it is for them that a detailed strategy of action ought to be worked out. There are about 20 groups of diagnoses where the calculated cost of innovation exceed 50 million PLN throughout the last three years: for cancers where new medicines were introduced. There is a great and sustaining hiatus in the analysed period (around 50%) between the reported diagnoses and the confirmed diagnoses for the ill persons that are treated. This requires more detailed analyses.