OBJECTIVES

Ovarian cancer caused 22,500 deaths in 2015 in China, the highest in gynecology oncology. Besides existed estimations on disease burden for the whole society, how much it costs for patients and their families should be known to support medical insurance decision making, as it aims to reduce poverty due to illness efficiently, while minimize risk of deficit. This review is to analysis the data gap.

METHODS

We searched for Chinese literatures in CNKI. Search pattern was “ovarian cancer” AND “cost OR budget OR medical insurance OR burden OR care” in abstract. Publication deadline was Dec 1th, 2017. Studies published only in abstract or not focused on ovarian cancer are excluded.

RESULTS

Finally, we got 13 papers. 11 include only medical costs, without any analysis on surgery. 2 are family caregivers burden. 12 based on real-world patient level data. 11 sample are from single hospitals, with 7 smaller than 100. Though 6 samples are from 3+ years, only 1 analysis time factor. The most common treatment is paclitaxel + carboplatin without maintenance treatment, with total medical expenditure $13,028-20,186. Cost per cycle varies by drugs and data resources, but most around $3,100. A study finds original paclitaxel treatment costs 2 times more than generic. Maintenance treatment adds significant extra expenditure, $7,764 for Docetaxel maintenance, $24,845 for Bevacizumab. 54-85% expenditure is for drugs, and 20-50% drugs are adjuvant. Average hospitalization expenditure is around $1,475. 1/3 family caregivers are in heavy pressure, and 89.5% have financial risks.

CONCLUSIONS

Ovarian cancer cost a lot to patients and their families, both medical and informal care. Efforts in insurance efficiency will improve survivorship experience. But facing the fact targeted therapies coming, decision makers are in urgent need of good multi-center real world evidence on total costs of patient life cycle, including surgery.