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Original Research

Open Access

Resource utilisation and cost of cervical cancer and dysplasia in Croatia

  • A. Ivičević Uhernik1,*,
  • M. Vajagić2
  • M. Jelavić3
  • A. Cesarec2
  • A. Lučić2
  • M. Jovanović2
  • Z. Lovrić1
  • M. Šekerija1

1Croatian Institute of Public Health, Zagreb, Croatia

2Croatian Health Insurance Fund, Zagreb, Croatia

3Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia

DOI: 10.12892/ejgo4210.2019 Vol.40,Issue 1,February 2019 pp.40-47

Accepted: 08 May 2017

Published: 10 February 2019

*Corresponding Author(s): A. Ivičević Uhernik E-mail: ana.ivicevic@hzjz.hr

Abstract

Purpose of investigation: To analyse resource utilisation and costs due to cervical cancer and dysplasia in Croatia. Materials and Methods: Patients diagnosed with cervical cancer were identified from the Croatian National Cancer Registry. Resource utilisation and costs of cervical cancer treatment for the period of five years after the date of diagnosis were retrieved from the Croatian Health Insurance Fund Claims Database. Patients diagnosed with cervical dysplasia were identified and their resource utilisation and treatment costs during one year following diagnosis were obtained from the Croatian Health Insurance Fund Claims Database. Results were calculated for different healthcare services and disease stages. Results: There were 346 patients diagnosed with cervical cancer in 2008. Total costs of treatment in the five-year period were 2,177,071 Euros, while average cost of treatment per patient was 6,403 Euros. The largest shares of total costs were costs for hospitalisations (73%), followed by outpatient healthcare (17%), and personal sick leave (7%). There were also 14,913 patients with cervical dysplasia diagnosed in 2012. Total costs of their treatment during one year after the diagnosis were 1,609,073 Euros, with average costs per patient of 108 Euros. Outpatient care (48%), followed by hospitalisations (45%), and prescribed medicines (6%) had the greatest share of total costs. Conclusion: Treatment of cervical cancer and dysplasia in Croatia is associated with significant costs and healthcare resource utilisation.


Keywords

Cervical cancer; Cervical dysplasia; Resource utilisation; Cost of illness

Cite and Share

A. Ivičević Uhernik,M. Vajagić,M. Jelavić,A. Cesarec,A. Lučić,M. Jovanović,Z. Lovrić,M. Šekerija. Resource utilisation and cost of cervical cancer and dysplasia in Croatia. European Journal of Gynaecological Oncology. 2019. 40(1);40-47.

References

[1] Ferlay J., Soerjomataram I., Ervik M., Dikshit R., Eser S., Mathers C., et al.: “GLOBOCAN 2012 v1.0, Cancer Incidence and Mortal- ity Worldwide: IARC CancerBase No. 11”. Lyon, France: International Agency for Research on Cancer, 2013. Available at: URL: http://globocan.iarc.fr.

[2] Ferlay J., Steliarova-Foucher E., Lortet-Tieulent J., Rosso S., Co- ebergh JW., Comber H., et al.: “Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012”. Eur. J. Cancer, 2013, 49, 1374.

[3] Kelava I., Tomičić K., Kokić M., Ćorušić A., Planinić P., Kirac I., et al.: “Breast and gynecological cancers in Croatia”. 1988-2008. Croat. Med. J., 2012, 53, 100.

[4] Croatian Institute of Public Health, Croatian National Cancer Registry: “Cancer Incidence in Croatia 2013, Bulletin No. 38”. Zagreb: Croatian Institute of Public Health, 2015.

[5] Sant M., Chirlaque Lopez MD., Agresti R., Sanchez Perez MJ., Hol- leczek B., Bielska-Lasota M., et al.: “Survival of women with cancers of breast and genital organs in Europe 1999-2007: results of the EUROCARE-5 study”. Eur. J. Cancer, 2015, 51, 2191.

[6] OECD: Health At a Glance 2007: OECD Indicators”. Paris: OECD Publishing, 2007.

[7] Maver P.J., Seme K., Korac T., Dimitrov G., Dobrossy L., Engele L., et al.: “Cervical cancer screening practices in central and eastern Europe in 2012”. Acta Dermatovenerol. Alp. Pannonica. Adriat., 2013, 22, 7.

[8] Znaor A., Strnad M.: “Cervical cancer in Croatia: state of the art and possibilities for prevention. Coll. Antropol., 2007, 31, 37.

[9] Ministry of Health of the Republic of Croatia: “Protocol of National Cervical Cancer Early Detection Programme [Internet]”. Zagreb: Ministry of Health of the Republic of Croatia, 2012. Available at: http://citologija.hlz.hr/wp-content/uploads/2014/12/PROTOKOL- nacionalnog-programa-ranog-otkrivanja-raka-vrata-maternice.pdf [Article in Croatian]

[10] Arbyn M., Anttila A., Jordan J., Ronco G., Schenck U., Segnan N., et al.: “European guidelines for quality assurance in cervical cancer screening - summary document”. Ann. Oncol., 2010, 21, 448.

[11] Dzakula A., Sagan A., Pavic N., Loncarek K., Sekelj-Kauzlaric K.: “Croatia: health system review”. Health. Syst. Transit., 2014, 16, 1.

[12] Tang C.H., Pwu R.F., Tsai I.C., Wang H.I., You S.L., Chen C.A., et al.: “Costs of cervical cancer and precancerous lesions treatment in a publicly financed health care system”. Arch. Gynecol. Obstet., 2010, 281, 683.

[13] Croatian National Bank [Internet]. Zagreb: “Croatian National Bank Midpoint exchange rates of the Croatian National Bank (period av- erage)”. Available at: https://www.hnb.hr/-/srednji-tecaj-hnb-a

[14] Croatian Bureau of Statistics: “Statistical Yearbook of the Republic of Croatia 2015”. Zagreb: Croatian Bureau of Statistics, 2015. Avail- able at: http://www.dzs.hr/Hrv_Eng/ljetopis/2015/sljh2015.pdf

[15] Bradley C.J., Yabroff K.R., Dahman B., Feuer E.J., Mariotto A., Brown M.L.: “Productivity costs of cancer mortality in the United States: 2000-2020”. J. Natl. Cancer Inst., 2008, 100, 1763.

[16] Castellsague X., Remy V., Puig-Tintore, L.M., de la Cuesta R.S., Gonzalez-Rojas N., Cohet C.: “Epidemiology and costs of screening and management of precancerous lesions of the cervix in Spain”. J. Low Genit. Tract Dis., 2009, 13, 38.

[17] Shavit O., Raz R., Stein M., Chodick G., Schejter E., Ben-David Y., et al.: “Evaluating the epidemiology and morbidity burden associated with human papillomavirus in Israel: accounting for CIN1 and genital warts in addition to CIN2/3 and cervical cancer”. Appl. Health. Econ. Health Policy, 2012, 10, 87.

[18] Henk H.J., Insinga R.P., Singhal P.K., Darkow T.: “Incidence and costs of cervical intraepithelial neoplasia in a US commercially insured population”. J. Low Genit. Tract. Dis., 2010, 14, 29.

[19] Salo H., Leino T., Kilpi T., Auranen K., Tiihonen P., Lehtinen M., et al.: “The burden and costs of prevention and management of genital disease caused by HPV in women: a population-based registry study in Finland”. Int. J. Cancer, 2013, 133, 1459.

[20] Wolstenholme J.L., Whynes D.K.: “Stage-specific treatment costs for cervical cancer in the United Kingdom”. Eur. J. Cancer, 1998, 34, 1889.

[21] Ricciardi A., Largeron N., Giorgi Rossi P., Raffaele M., Cohet C., Federici A., et al.: “Incidence of invasive cervical cancer and direct costs associated with its management in Italy”. Tumori, 2009, 95, 146.

[22] Berraho M., Najdi A., Mathoulin-Pelissier S., Salamon R., Nejjari C.: “Direct costs of cervical cancer management in Morocco”. Asian Pac. J. Cancer P., 2012, 13, 3159.

[23] Nowakowski A., Śliwczyński A., Seroczyński P., Cybulski M., Teter Z.: “Reimbursed Costs of Management of Uterine Cervical Lesions in Poland - a Descriptive Analysis Based of Data from the National Health Fund and the Ministry of Health“. Centr. Eur. J. Public Health, 2016, 24, 163.

[24] Kostova P.: “Cost-effectiveness of cervical screening”. Akusherstvo i ginekologii︠a︡ (Sofia), 2007, 46, 32. [Article in Bulgarian]

[25] Ćorušić A., Karadža M., Planinić P., Škrgatić L., Ljubojević-Grgec D., Juras J., et al.: “Pharmacological Cost-benefit Analysis of Vaccination of Adolescents by Cervarix”. Gynaecol. Perinatol., 2011, 20, 21. [Article in Croatian].

[26] Eurostat database [Internet]: “Luxembourg: Eurostat”, 2016. Available at: http://ec.europa.eu/eurostat/data/database

[27] Kralj V., Brkić Biloš I., Ćorić T., Silobrčić Radić M., Šekerija M.: “Chronic noncommunicable diseases - burden of disease in the population of Croatia”. Cardiol. Croat., 2015, 10, 167.

[28] Voncina L., Strizrep T., Bagat M., Pezelj-Duliba D., Pavic N., Polasek O.: “Croatian 2008-2010 health insurance reform: hard choices toward financial sustainability and efficiency”. Croat. Med. J., 2012, 53, 66.

[29] Brown M.L., Riley G.F., Schussler N., Etzioni R.: “Estimating health care costs related to cancer treatment from SEER-Medicare data”. Med. Care, 2002, 40, 104.

[30] Mariotto A.B., Yabroff K.R., Shao Y., Feuer E.J., Brown M.L.: “Projections of the cost of cancer care in the United States: 2010-2020”. J. Natl. Cancer I., 2011, 103, 117.

[31] Brown R.E., Breugelmans J.G., Theodoratou D., Benard S.: “Costs of detection and treatment of cervical cancer, cervical dysplasia and genital warts in the UK”. Curr. Med. Res. Opin., 2006, 22, 663.

[32] Subramanian S., Trogdon J., Ekwueme D.U., Gardner J.G., Whitmire J.T., Rao C.: “Cost of cervical cancer treatment: implications for providing coverage to low-income women under the Medicaid expansion for cancer care”. Women Health Iss., 2010, 20, 400.

[33] Insinga R.P., Glass A.G., Rush B.B.: “The health care costs of cervical human papillomavirus—related disease”. Am. J. Obstet. Gynecol., 2004, 191, 114.

[34] van Ballegooijen M., Koopmanschap MA., Habbema JD.: “The management of cervical intra-epithelial neoplasia (CIN): extensiveness and costs in The Netherlands”. Eur. J. Cancer, 1995, 31, 1672.

[35] Giorgi Rossi P., Ricciardi A., Cohet C., Palazzo F., Furnari G., Valle S., et al.: “Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy”. BMC Public Health, 2009, 9, 71.

[36] Dickson RJ.: “Management of carcinoma of the cervix”. Practitioner, 1980, 224, 899.

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