Włodek B1, Jakubczyk M2, Niewada M2, Bojanic L3, Zawodnik S4, Bojkow S4, Chahoud L5, Sweeney N6, Benkovic V3, Christodoulou C7, Dimitrova M8, Liepina E9, Ondrusova M10, Pana A11, Petrova G8, Petrovica M12, Ulici A13
1HealthQuest, Warsaw, MZ, Poland, 2HealthQuest, Warsaw, Poland, 3Novartis Hrvatska d.o.o., Zagreb, Croatia, 4Novartis Oncology Sp. z o.o., Warsaw, Poland, 5Novartis Oncology, Basel , BS, Switzerland, 6Novartis Oncology, London, UK, 7Metropolitan Hospital, N.Faliro, Greece, 8Medical University of Sofia, Sofia, Bulgaria, 9The Center for Disease Prevention and Control, Riga, Latvia, 10Pharm-In, spol. s r. o., Bratislava, BL, Slovakia, 11Center for Health Outcomes & Evaluation, Bucharest, Romania, 12Medical Doctor at Riga East Clinical University Hospital, Riga, Latvia, 13Rosana medical, Bucharest, Romania
OBJECTIVES Breast cancer (BC) is the most frequently diagnosed and the leading cause of death amongst cancers in women. Understanding its burden is important in healthcare management (e.g. drug or health programs appraisals). The study assessed the burden of advanced BC (ABC) in Bulgaria, Croatia, Czechia, Estonia, Greece, Israel, Latvia, Poland, Romania, and Slovak Republic. METHODS The data were collected in individual countries with a unified questionnaire (covering epidemiology, mortality, treatment patterns, and economic aspects) based on databases/registries, published studies, or experts’ opinions. The doubts, inconsistencies and missing data were discussed and addressed. RESULTS BC prevalence is highest in Czechia (1,647/100,000 women), and lowest in Romania (506/100,000 women). ABC constitutes approx. 20% of BC. The annual mortality in ABC ranges from 8.8% (Czechia) to 12.9% (Romania). The number of years of potential life lost ranges between approx. 2,000 (Estonia) and 55,000 (Poland), also leading to the productive years loss (accounting for retirement age and employment activity): between 250 (Estonia) and 7,000 (Poland) and the indirect cost of approx. 4 million EUR and 76 million EUR, respectively. The average indirect cost is estimated at approx. 600,000 EUR per 100,000 women. Although diagnostics and treatment patterns are rather similar between the countries still, some differences occur: e.g. >60% in Bulgaria and Poland use psychologist support, while only 5% in Czechia. CONCLUSIONS This study represents the first attempt to assess the ABC burden in multiple countries. The burden of ABC comes from direct medical costs but also indirect cost due to mortality. Our findings may be used in decision making on healthcare resources allocation (supporting national cancer plans or as input in economic analyses), as a timely diagnosis, early treatment and access to innovative treatments hold potential to decrease burden of ABC.