GROWTH IN ADVANCED-STAGE CANCER TREATMENT COSTS IN ENGLAND REFLECTING RISING CANCER PRESCRIBING EXPENDITURES
Author(s)
Ali Tafazzoli, PhD1, Anuraag Kansal, PhD2, Libby Ellis, PhD3, Ewan Gray, PhD4, Peter S. Hall, PhD5.
1HEOR Director, GRAIL, Inc., Bethesda, MD, USA, 2GRAIL, Piedmont, CA, USA, 3GRAIL, Inc., London, United Kingdom, 4GRAIL, London, United Kingdom, 5The University of Edinburgh, Kinross, United Kingdom.
1HEOR Director, GRAIL, Inc., Bethesda, MD, USA, 2GRAIL, Piedmont, CA, USA, 3GRAIL, Inc., London, United Kingdom, 4GRAIL, London, United Kingdom, 5The University of Edinburgh, Kinross, United Kingdom.
OBJECTIVES: Prescription spending on cancer drugs in England has increased substantially, yet detailed estimates by cancer type and stage remain limited beyond 2019. This study projected growth in cancer treatment costs by type and stage based on an estimated apportionment of rising cancer prescribing expenditures from 2019-2026 in England.
METHODS: We used National Prescribing Costs in Hospitals and the Community (PCHC) data to quantify total spending growth. Spending increases in the malignant disease category were assumed to be driven by high-usage oncology therapies, including immuno-oncology and targeted agents while excluding therapies with plateaued uptake. These therapies were identified from recent NICE Innovation Scorecard uptake data, and related NICE Technology Appraisals (TAs) were reviewed and assigned to cancer types and stages accordingly. The projected increase in prescribing costs was then apportioned based on relative ratio of TA approvals and cancer incidence across cancer types and stages. Indication-level eligibility, uptake, and pricing were not explicitly incorporated.
RESULTS: Annual malignant disease prescribing costs increased from £1.58B in 2019 to £2.82B in 2024 and are projected to reach £3.32B-£3.56B by 2026 under linear and log-linear growth assumptions. Among 106 identified high-usage TA approvals (2015-2025), most were concentrated in advanced-stage disease (stage IV: 53%, stage III: 29%, stage II: 8%, non-staged haematologic: 10%) with 11% specific to stage IV lung cancer. From 2019-2026, the largest estimated increase in annual treatment costs was observed for stage IV lung cancer (£25,479-£28,902), non-staged haematologic (£23,356-£26,493), stage III lung and stage IV lymphoma (£14,863-£16,859 each), stage IV melanoma (£12,739-£14,451), and stage IV breast, prostate, and colorectal cancers (£10,616-£12,042 each).
CONCLUSIONS: Across cancers, treatment cost growth was projected to be higher in advanced-stage disease, characterized by intensive treatment and a greater concentration of newer indications. These findings highlight the potential value of earlier detection to mitigate long-term costs.
METHODS: We used National Prescribing Costs in Hospitals and the Community (PCHC) data to quantify total spending growth. Spending increases in the malignant disease category were assumed to be driven by high-usage oncology therapies, including immuno-oncology and targeted agents while excluding therapies with plateaued uptake. These therapies were identified from recent NICE Innovation Scorecard uptake data, and related NICE Technology Appraisals (TAs) were reviewed and assigned to cancer types and stages accordingly. The projected increase in prescribing costs was then apportioned based on relative ratio of TA approvals and cancer incidence across cancer types and stages. Indication-level eligibility, uptake, and pricing were not explicitly incorporated.
RESULTS: Annual malignant disease prescribing costs increased from £1.58B in 2019 to £2.82B in 2024 and are projected to reach £3.32B-£3.56B by 2026 under linear and log-linear growth assumptions. Among 106 identified high-usage TA approvals (2015-2025), most were concentrated in advanced-stage disease (stage IV: 53%, stage III: 29%, stage II: 8%, non-staged haematologic: 10%) with 11% specific to stage IV lung cancer. From 2019-2026, the largest estimated increase in annual treatment costs was observed for stage IV lung cancer (£25,479-£28,902), non-staged haematologic (£23,356-£26,493), stage III lung and stage IV lymphoma (£14,863-£16,859 each), stage IV melanoma (£12,739-£14,451), and stage IV breast, prostate, and colorectal cancers (£10,616-£12,042 each).
CONCLUSIONS: Across cancers, treatment cost growth was projected to be higher in advanced-stage disease, characterized by intensive treatment and a greater concentration of newer indications. These findings highlight the potential value of earlier detection to mitigate long-term costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE673
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology