Toward a Framework to Assess the Financial and Economic Burden of Cervical Cancer in Low- and Middle-Income Countries: A Systematic Review.

IF 3.2 Q2 ONCOLOGY JCO Global Oncology Pub Date : 2024-08-01 DOI:10.1200/GO.24.00066
Ahmad Fuady, Didik Setiawan, Irene Man, Inge M C M de Kok, Iacopo Baussano
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Abstract

Purpose: To review the economic burden assessment of cervical cancer in low- and middle-income countries (LMICs) and use the findings to develop a pragmatic, standardized framework for such assessment.

Methods: We first systematically reviewed articles indexed in scientific databases reporting the methodology for collecting and calculating costs related to the cervical cancer burden in LMICs. Data on study design, costing approach, cost perspective, costing period, and cost type (direct medical costs [DMC], direct nonmedical costs [DNMC], and indirect costs [IC]) were extracted. Finally, we summarized the reported limitations in the methodology and used the solutions to inform our framework.

Results: Cervical cancer treatment costs across LMICs vary greatly and can be extremely expensive, up to 70,968 International US dollars. Economic and financial assessment methods also vary greatly across countries. Of the 28 reviewed articles, 25 studies reported DMC for cervical cancer treatment by extracting cost information from billing or insurance databases (eight studies), conducting surveys (five), and estimating the costs (12). Only 11 studies-mainly through surveys-reported DNMC and IC. The economic burden assessment framework includes health care/payer and societal perspectives (DMC, DNMC, IC, and human capital loss) across the cervical cancer screening and treatment continuum. To assess health care/payer costs, we recommend combining the predefined treatment standards with actual local treatment practices, multiplied by unit costs. To assess societal costs, we recommend conducting a cost survey in line with a standardized yet adaptable protocol.

Conclusion: Our standardized, pragmatic framework allows assessment of economic and financial burden of cervical cancer in LMICs despite the different levels of available resources across countries. This framework will facilitate global comparisons and monitoring and may also be applied to other cancers.

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中低收入国家宫颈癌财政和经济负担评估框架:系统回顾。
目的:回顾中低收入国家(LMICs)的宫颈癌经济负担评估,并利用研究结果为此类评估制定实用的标准化框架:我们首先系统地查阅了科学数据库中索引的文章,这些文章报道了收集和计算中低收入国家宫颈癌负担相关成本的方法。我们提取了有关研究设计、成本计算方法、成本角度、成本计算期和成本类型(直接医疗成本 [DMC]、直接非医疗成本 [DNMC] 和间接成本 [IC])的数据。最后,我们总结了所报告的方法局限性,并利用这些局限性为我们的框架提供了解决方案:结果:在低收入和中等收入国家,宫颈癌的治疗成本差异很大,而且可能非常昂贵,最高可达 70,968 美元。各国的经济和财务评估方法也大相径庭。在 28 篇综述文章中,有 25 项研究通过从账单或保险数据库中提取成本信息(8 项研究)、开展调查(5 项研究)和估算成本(12 项研究)来报告宫颈癌治疗的 DMC。只有 11 项研究(主要通过调查)报告了 DNMC 和 IC。经济负担评估框架包括宫颈癌筛查和治疗整个过程中的医疗/纳税人和社会角度(DMC、DNMC、IC 和人力资本损失)。为评估医疗保健/纳税人成本,我们建议将预定义治疗标准与当地实际治疗实践相结合,再乘以单位成本。为了评估社会成本,我们建议按照标准化但可调整的方案进行成本调查:尽管各国的可用资源水平不尽相同,但我们的标准化务实框架可以评估低收入和中等收入国家宫颈癌的经济和财务负担。这一框架将有助于进行全球比较和监测,也可应用于其他癌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JCO Global Oncology
JCO Global Oncology Medicine-Oncology
CiteScore
6.70
自引率
6.70%
发文量
310
审稿时长
7 weeks
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