Trends and drivers of pharmaceutical expenditures from systemic anti-cancer therapy

Lars Børty (), Rasmus F. Brøndum, Heidi S. Christensen, Charles Vesteghem, Marianne Severinsen, Søren P. Johnsen, Lars H. Ehlers, Ursula Falkmer, Laurids Ø. Poulsen and Martin Bøgsted
Additional contact information
Lars Børty: Aalborg University Hospital
Rasmus F. Brøndum: Aalborg University Hospital
Heidi S. Christensen: Aalborg University Hospital
Charles Vesteghem: Aalborg University Hospital
Marianne Severinsen: Aalborg University Hospital
Søren P. Johnsen: Aalborg University
Lars H. Ehlers: Aalborg University
Ursula Falkmer: Aalborg University Hospital
Laurids Ø. Poulsen: Aalborg University Hospital
Martin Bøgsted: Aalborg University Hospital

The European Journal of Health Economics, 2023, vol. 24, issue 6, No 1, 853-865

Abstract: Abstract Expenditures on medicine for systemic anti-cancer therapy (SACT) have seen large increases in recent years. The characterization of patients with high SACT costs is crucial to identify cost-driving factors, but little is known about the distribution of expenditures at the patient-level. We priced 260,834 registrations of SACT for 12,589 patients from 2008 to 2019 by combining them with product-level billings of EUR 142.1 million. Based on this, we defined high-cost patients as the 2.5% most expensive by accumulated SACT expenditures. We found that high-cost patients accounted for 28.8% of the total SACT expenditures and were observed across all major cancer groups except for pancreatic cancer. The risk of becoming a high-cost patient was increased for younger age groups, i.e., 18–44 and 45–64 years, for patients with BMI ≥ 25, and for patients with multiple cancer diagnoses, while no alteration of risk was observed due to comorbidities or sex. Changes in the characteristics of high-cost patients during the study period were found with an increased risk of becoming high-cost in later years for elderly patients and patients with lung cancer and a decreased risk for breast cancer patients.

Keywords: Systemic anti-cancer therapy; Medicine expenditures; High utilizers; High-cost patients; Expensive patients; Oncology (search for similar items in EconPapers)
JEL-codes: C5 D4 D6 I11 I14 I18 (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10198-022-01515-0

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