Cost of illness for colorectal cancer at low middle income countries Egypt case

Abstract

Introduction: According to international statistics colorectal cancer (CRC) is the third most common cancer. Two-thirds of all colorectal cancers occur in the more developed regions of the world. Egypt with the population with 100 million people (CRC) may represent a pressure on health care system and developing some questions need answers like: Are the polices for CRC treatment efficient for the health care system? Does health care systemneed new treatments? What is the outcome for present treatment polices? The objective of this study is to estimate the total medical cost of illness (CRC) to improve understanding of the economic consequences of different health-care policies from the payer prospective for the last 3 years with analysis of treatments used. Methods: Data from patients aged (18 -60 years) for the last 3 years including direct and indirect health care costs for conventional treatment as it was not including (cost of treatment, complications including, Rehabilitation. Metastatic, outpatients costs). The total (n) of patients enrolled in the national database =20389 weighted average method was used for calculations for cost and consequences. The value of lost productivity using Egyptian estimates for the value of a statistical life year (VSLY). Outcomes was calculated in form of QALY. Several methods were employed to reach an average. Value for a QALY: lost production represented by actual per capita annual proEarnings based on the average national salary and VSLY. Lost production: annual productivity was calculated by dividing the gross domestic product (GDP) by the labour force (ages 20-65). GDP in 2012 came from the World Bank, and the labour force came from CAPMAS. Lost earning: average annual salary was calculated from CAPMAS for the year 2012, and adjusted by the annual salary increase. VSLY: The value of a statistical life (VSL) in Egypt was calculated from the average of the following methods: (a) Examining the ratio between GDP per capita in Egypt to countries with published GDP and VSLductivity of the labour force, lost Uncertainty Analyses: To test the stability of our results to variation in the estimates of the input model parameters, onedimensional sensitivity analyses were performed. Results: Mean direct cost for CRC is amounted (610) Dollar per patient per year 80% of total expenditures where chemotherapy, surgery represent 4.7% of expenditures and radio therapy represents 1.7%. Costs increase in the metastatic phase than primary phase QALY gained for metastatic patients receiving biological treatment was 1.9 QALY versus .4 QALY with conventional chemotherapy. Conclusion: Reforming treatment polices for CRC in Egypt become a need the new polices should include Early detecting programs reimbursement for of Biological products after establishing treatment guidelines based on multiple criteria including (socioeconomic impact, economic values, efficacy parameters).