OBJECTIVES : to evaluate the hospital resource use and treatment pathways associated with management of ovarian cancer (OC) patients in Kazakhstan.

METHODS: Anonymised longitudinal electronic health records and cost claims from National Cancer Registry for 2017-2018 representing all registered cancer patients in the country were retrospectively analysed. Eligible patients were females aged≥18 diagnosed with diagnosis of OC (ICD-10 C.56). Total direct healthcare costs per patient per year (such as hospitalisation, treatment, outpatient, remedy) were estimated and inflated accordingly to 2019. Treatment pathways were studied according to the stage and age differences among patients, including types of chemotherapy, surgeries, prescriptions, side effects, and complications.

RESULTS: The sample included 16,339 individual records for 3042 patients (mean age 55.21; 29% Stage I-II, 64% Stage III; 70% urban residents, 20% from Astana and Almaty). Mean total direct costs per patient per year were estimated as 978,132 KZT (2,545 USD). On average each patient was hospitalised for 47,35 days. Mean cost per hospitalisation day was estimated as 40,300 KZT (105 USD). 14% of hospitalisations were aimed at treating the initial tumour, 60% - continuing treatment of the initial tumour, 18% - treatment of OC recurrence. 82% of admissions to hospital were for chemotherapy (36% adjuvant), 11% for surgery (34% bilateral oophorectomy). The most common side effects reported after chemotherapy were gastrointestinal (26%).

CONCLUSIONS: Complex treatment pathways were observed for patients with stage II and III OC in Kazakhstan. This observational analysis of OC in Kazakhstan is the first of its kind, providing comprehensive estimates of economic burden associated in OC that lay a foundation for future research in Central Asia. Further research is needed to explore the estimates of indirect and out-of-pocket costs associated with OC across different age groups and regions in Kazakhstan.