BEYOND THE HEALTHCARE BUDGET: INDIRECT COSTS AS A MAJOR DRIVER OF THE ECONOMIC BURDEN OF CHRONIC DISEASES IN POLAND
Author(s)
Karolina Skóra, MPH, MSc1, Joanna Augustynska, MSc2, Michal Seweryn, PhD3.
1EconMed Europe, Wola Zachariaszowska, Poland, 2EconMed Europe, Krakow, Poland, 3Head of Postgraduate Studies, EconMed Europe, Krakow, Poland.
1EconMed Europe, Wola Zachariaszowska, Poland, 2EconMed Europe, Krakow, Poland, 3Head of Postgraduate Studies, EconMed Europe, Krakow, Poland.
OBJECTIVES: To assess the extent to which indirect costs, contribute to the societal economic burden of selected chronic diseases in Poland, and to illustrate how analyses restricted to direct healthcare expenditure may underestimate the true impact of disease.
METHODS: A comparative cost-of-illness analysis was performed using four disease-specific reports for breast cancer, lung cancer, haemophilia, and age-related macular degeneration/diabetic macular oedema (AMD/DME). The reports used data from the National Health Fund and patient surveys. Direct costs included public healthcare expenditure and, when available, patients’ out-of-pocket costs. Indirect costs were estimated with the human capital approach and included productivity losses due to absenteeism, presenteeism, disability, informal caregiving, unpaid work and, for breast and lung cancer, premature mortality. Total societal costs and the relative contribution of each cost category were compared across disease areas.
RESULTS: The total societal burden varied substantially across disease areas. Indirect costs constituted a major component of total costs in all analysed conditions, ranging from 45% in haemophilia to 84% in AMD/DME. Their contribution was particularly high in AMD/DME and breast cancer, where they accounted for 84% and 73% of total costs, respectively. Indirect cost structures differed by disease, reflecting work impairment, disability, caregiving needs and mortality. Presenteeism drove AMD/DME burden, while absenteeism, unpaid work, informal caregiving and premature mortality contributed substantially to cancer burden. These findings indicate that direct medical expenditure captures only part of the economic impact of chronic diseases.
CONCLUSIONS: The economic burden of chronic diseases in Poland extends far beyond healthcare expenditure. Indirect costs represent a major component of societal costs and should be systematically incorporated into healthcare decision-making, resource allocation, and health technology assessment. Limiting analyses to direct medical costs may substantially underestimate the value of interventions that preserve work ability, reduce disability, and lessen the broader societal impact of disease.
METHODS: A comparative cost-of-illness analysis was performed using four disease-specific reports for breast cancer, lung cancer, haemophilia, and age-related macular degeneration/diabetic macular oedema (AMD/DME). The reports used data from the National Health Fund and patient surveys. Direct costs included public healthcare expenditure and, when available, patients’ out-of-pocket costs. Indirect costs were estimated with the human capital approach and included productivity losses due to absenteeism, presenteeism, disability, informal caregiving, unpaid work and, for breast and lung cancer, premature mortality. Total societal costs and the relative contribution of each cost category were compared across disease areas.
RESULTS: The total societal burden varied substantially across disease areas. Indirect costs constituted a major component of total costs in all analysed conditions, ranging from 45% in haemophilia to 84% in AMD/DME. Their contribution was particularly high in AMD/DME and breast cancer, where they accounted for 84% and 73% of total costs, respectively. Indirect cost structures differed by disease, reflecting work impairment, disability, caregiving needs and mortality. Presenteeism drove AMD/DME burden, while absenteeism, unpaid work, informal caregiving and premature mortality contributed substantially to cancer burden. These findings indicate that direct medical expenditure captures only part of the economic impact of chronic diseases.
CONCLUSIONS: The economic burden of chronic diseases in Poland extends far beyond healthcare expenditure. Indirect costs represent a major component of societal costs and should be systematically incorporated into healthcare decision-making, resource allocation, and health technology assessment. Limiting analyses to direct medical costs may substantially underestimate the value of interventions that preserve work ability, reduce disability, and lessen the broader societal impact of disease.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE531
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology, Rare & Orphan Diseases, Sensory System Disorders (Ear, Eye, Dental, Skin)