Early Direct Costs of Diagnostic and Therapeutic Services for Patients with Cancer: A Descriptive Study in Semnan, Iran, 2011 - 2014

Objectives: Knowledge about the pattern and direct costs of medical services allocated to a given disease in a particular community can help to realize its economic burden in that community better regarding its socioeconomic features. A significant part of medical diagnostics and therapeutics for patients with cancer is made within three to six months after its detection, and their related costs are named as early direct costs. The current study aimed at evaluating the early direct costs of the incidence of cancer in a sample of Iranian patients. Methods: The current descriptive study was conducted on some patients with cancer referred to the only oncology clinic in Semnan city, Iran, from 2011 to 2014 for chemotherapy. Some primary information about the type of services received and their direct costs, and also some demographics and social characteristics were gathered from patients' medical records. Costs were converted to US dollars and their means ± standard deviation (SD) were reported. Results: Fifty patients participated in the study. The most common types of cancer were breast cancer (n = 18, 36%), followed by colorectal cancer (n = 13, 26%). Other types included the esophagus, gastric, pancreas, lymphoma, ovarian, leukemia, and nasopharyngeal carcinomas. The mean ± SD of cost for doctor visits was US$1666.58 ± 41.64, US$221.97 ± 149.72, for imaging, US$200.55 ± 86.62 for lab tests, US$693.70 ± 530.90 for drugs, US$375.18 ± 156.89 for chemotherapy, US$492.03 ± 774.87 for surgical hospitalization, and US$75.86 ± 40.26 for non-surgical services, with the total average cost of US$2164.52 ± 1156.56. The total calculated early direct costs to manage colorectal cancer were estimated US$3017.26, and for breast cancer US$1923.23. No difference was observed in the costs of services including doctor’s visits, imaging, laboratory tests, medications, or non-surgical services among the different subtypes of cancers; however, higher costs for chemotherapy and surgical services were specified to colorectal cancer. Conclusions: The study findings suggested that the economic burden of colorectal cancer in Iran was larger than the other types of cancer regarding its early direct costs.