The medical cost of liver cancer in a referral hospital in Indonesia during 2020

Abstract

Liver cancer inflicts a severe human and economic burden on patients, their families, and society. However, the cost-of-illness analysis of liver cancer and the patient-level data on healthcare resource use is still limited. This study aims to estimate the medical costs of liver cancer in Indonesia. A costing study using a provider perspective approach was employed. Direct medical cost data were retrieved retrospectively from medical records of 157 liver cancer patients divided into three disease categories [compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC)] from January to December 2020 from a large referral hospital in Yogyakarta, Indonesia. A bottom-up methodology based on the patient's perspective was used to calculate the cost. The estimated medical costs for the nation were obtained from the direct medical cost per patient per liver cancer stage multiplied by the number of the patients. The total direct medical cost attributable to liver cancer in 2020 was estimated to be approximately US$3.8 million. The cost of surgery was the major contributor to liver cancer treatment in every stage. The annual direct medical cost per patient increased with the severity of the disease, with the estimated cost for CC, DC, and HCC as US$20,339, $24,784, and $26,538, respectively. Liver cancer imposes a valuable burden not only on patients but also on the healthcare system. Effective interventions in the healthcare system are required to minimize the burden. However, the prevention of this disease such as healthy lifestyle changes, early screening, and vaccination would help the reduction in liver cancer incidence, reduction in mortality, and absolutely reduction in the cost of illness.