The economic burden of cancer in the UK: a study of survivors treated with curative intent

OBJECTIVE: We aim to describe the economic burden of UK cancer survivorship for breast, colorectal and prostate cancer patients treated with curative intent, 1 year post-diagnosis. METHODS: Patient-level data were collected over a 3-month period 12-15 months post-diagnosis to estimate the monthly societal costs incurred by cancer survivors. Self-reported resource utilisation data were obtained via the electronic Patient-reported Outcomes from Cancer Survivors system and included community-based health and social care, medications, travel costs and informal care. Hospital costs were retrieved through data linkage. Multivariate regression analysis was used to examine cost predictors. RESULTS: Overall, 298 patients were included in the analysis, including 136 breast cancer, 83 colorectal cancer and 79 prostate cancer patients. The average monthly societal cost was US 409 (95%CI: US 316- US 502) mean: £ 260, 95%CI: £ 198-£ 322 and was incurred by 92% of patients. This was divided into costs to the National Health Service (mean: US 279, 95%CI: US 207- US 351) mean: £ 177, 95%CI: £ 131-£ 224, patients' out-of-pocket (OOP) expenses (mean: US 40, 95%CI: US 15- US 65) mean: £ 25, 95%CI: £ 9-£ 42 and the cost of informal care (mean: US 110, 95%CI: US 57- US 162) mean: £ 70, 95%CI: £ 38-£ 102. The distribution of costs was skewed with a small number of patients incurring very high costs. Multivariate analyses showed higher societal costs for breast cancer patients. Significant predictors of OOP costs included age and socioeconomic deprivation. CONCLUSIONS: This study found the economic burden of cancer survivorship is unevenly distributed in the population and that cancer survivors may still incur substantial costs over 1 year post-diagnosis. In addition, this study illustrates the feasibility of using an innovative online data collection platform to collect patient-reported resource utilisation information.