OBJECTIVES: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death, causing high disease and economic burden in upcoming years. In spite of its popularity and importance of treatment, the number of research focusing on HCC-related treatment costs in Viet Nam is still limited, so this study aims to evaluate the treatment costs of HCC from the health insurance’s perspective of Vietnam.

METHODS: The decision-tree model was built based on the HCC treatment guideline of American Association for the Study of Liver Diseases – AASLD and Ministry of public health Viet Nam 2013 to estimate the direct treatment cost per patient per year. The data was collected in Bach Mai hospital - a large hospital specializing in HCC treatment in Viet Nam - from a cohort of all HCC patients in 2015. Costs included the unit costs of test, procedures, imaging, hospitalizations, medications, and all subsequent care of the HCC patients until either death or the end of follow-up.

RESULTS: Study sample included 216 patients with average age at 56.88 ± 0.74, 88% of men and 12% of women, 16.72 ± 0.99 days of the length hospital stay. Initial primary treatment modalities were sorafenib therapy 0.9%, RFA 5.6%, TACE 31.9%, symptomatic treatment 55.6% and liver surgery 6.0%. The decision-tree model was built with 11 steps to estimate the direct treatment cost of HCC. Overall costs included a median of VND 48,130,694 per patient per year; in which, 83% was covered by healthcare insurance and 17% by patients. The medical service cost was 4.8 times higher than the medication cost (VND 39.76 mil vs 8.37 mil).

CONCLUSIONS: The results show a considerable economic burden of HCC in Vietnam. With an upward trend of HCC in Vietnam and the high-cost burden of treatment, healthcare policies and national medical programs should be considered.