Economic Burden of Cervical Cancer in Bulgaria

OBJECTIVES: Bulgaria is among the countries with the highest burden of cervical cancers within the EU with life expectancy after diagnosis being below the EU average due to late diagnosis and suboptimal treatment options. The study aims to identify direct healthcare costs of cervical cancer in Bulgaria and to calculate indirect costs and years of life lost associated with cervical cancer.

METHODS: This was a retrospective, cost of illness study conducted from the payer perspective. Patients with a confirmed diagnosis of cervical cancer (ICD C53) were included. Drug utilization and administration costs and healthcare costing data were collected from the National Health Insurance Fund from January 2018 through December 2020. Years of life lost were calculated based on the country and gender-specific life expectancy. The human capital approach was used to calculate indirect costs due to productivity loss.

RESULTS: The total treatment costs for 3540 patients with cervical cancer in Bulgaria were 5 743 657 € (2018), 6 377 508 € (2019), and 6 751 182€ (2020). The costs associated with drug acquisition and administration contributed most to the final result (63%) followed by hospital management costs (14%). The costs of diagnosis and follow-up represented only 7% of total expenditures. An estimated 20 446 years of life were lost due to cervical cancer for the period 2018-2020. The total productivity losses were estimated at 7 578 014€.

CONCLUSIONS: The economic burden of cervical cancer in Bulgaria is considerable. Focus on prevention, early diagnosis, and higher vaccination coverage rates could contribute to lower costs.