The Evaluation of treatment costs of childhood cancers

Objectives: Cancer is one of the major medicosocial problems and it's economic aspects is not known very well in Turkey. In this report, the detection of economic burdens of childhood cancers to patient's family and government were aimed since effects on cancer therapy and survival. Patients and methods: In the first nine months duration of 1996, six months- 17 years-old 27 cancer patients, 8 with leukemia, 6 with lymphoma and 13 with solid tumors were followed up prospectively for one year, and costs of treatment were calculated. Results: Eight patients had leukemia(7 with ALL, 1 with AML), six had lymphoma(4 with Hodgkin's disease, 2 with non-Hodgkin lymphoma), and 13 had solid tumors. Forty-two neutropenic infection episodes were arised, in which 30 episodes were in leukemia group, 7 episodes in lymphoma group, and 5 episodes in solid tumors group. The mean total cost of treatment for the first year followed up 32554 USD in leukemia group, 8969 USD in lymphoma group, and 7078 USD in solid tumors group. When all childhood cancers were accounted together, the mean total cost of treatment was 15046 USD, and thirty-tree percent of this amount was attributed to neutropenic infections which were secondary to primary disease or treatment complications. According to relatively excess neutropenic infections in leukemia group, the mean cost of neutropenic infections treatment was highest by 14250 USD, and the mean cost of neutropenic infection per episode was also highest in this group by 3143 USD. In lymphoma group the mean cost of neutropenic infection was 1403 USD per patients, and 928 USD per episode. In solid tumors group, the mean cost of neutropenic infection was 352 USD per patient, and 983 USD per episode. There were positive strong correlation between cost of cancer treatment and anticancer drugs, antibiotics, blood-products, antiemetics and hospitalization costs. Conclusion: It is thought that this report called attention to economic problems of patients and families in cancers and could be a source to solve this problems in health-care planning. 82