Reflection on the financial aspects of caring for patients with colorectal carcinoma
Julius Špičák Orcid.org 1
+ Affiliation
Summary
Evaluation ofthe economics of care for patients with colorectal cancer is difficult because of the plethora of related changeable factors. The average length and quality of oncological care are increasing together with expenditures on the rising number of surviving oncological patients. In the USA, the costs of oncological care will increase by 27% by 2020, while the implementation of biological treatment prolongs survival by only 1.4 month. In Ireland, the costs of chemotherapy increased in the years 1994-2002 by more than two times. In Germany, expenditures on colorectal cancer care increased between 2002 and 2006 by 21.1%. The costs of chemotherapy increased by 33%. For the implementation of a screening programme, the capacity of endoscopic units is important. In the USA, more than 2.5 times more colonoscopies compared to the Czech Republic are performed, while in the Netherlands the number is lower. Here, an organized screening programme has recently been implemented based on FIT at two-year intervals and on colonoscopy. Gradual involvement of all the target population over 50 years of age is presumed with an increase in the number of colonoscopies of 50%. The comprehensive costs of screening are remarkable, the least costly being programmes based on TOK and sigmoidoscopy. Screening is clearly financially more advantageous than not implementing it and having to treat patients in advanced stages. It is also less costly in comparison with other screening programmes. Oncological care in the CR is under-funded and the whole system is financially efficient. Surgical care is relatively the most under-funded type of care.
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