title: Direct and indirect costs in a prospective cohort of patients with pancreatic cancer.
abstract: BACKGROUND
  Pancreatic cancer is an aggressive cancer with a low survival time. So far, there have been no studies assessing direct and indirect costs in individual patients.
  
  
  OBJECTIVE
  To assess prospectively the cost of illness in patients with pancreatic cancer.
  
  
  METHODS
  Patients were consecutively included at first admission to hospital. Sociodemographic factors, medical resource use and employment status were assessed by patient interviews and from medical records in a standardized way. Costs were calculated from the perspectives of the hospital, social insurance and society. Linear regression analyses were used to determine factors associated with costs.
  
  
  RESULTS
  A total of 57 patients were admitted with suspected pancreatic cancer. Of these patients, 45 (79%) had pancreatic cancer as final diagnosis, 11 (19%) pancreatitis and one patient cystadenoma. The median survival was 10.9 months in patients with pancreatic cancer. Per month of observation from societal perspective, total costs were 4075 for patients. Costs of hospitalizations were responsible for 75% of total costs. In multivariable analyses, surgery, a lower educational level, younger age, and the prevalence of metastases were significantly associated with higher total costs.
  
  
  CONCLUSIONS
  Costs are considerable in patients with pancreatic cancer. Our results may facilitate further economic evaluations and aid health policy-makers in resource allocation.
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charite University Medical Center, Berlin, Germany. jacqueline.mueller-nordhorn@charite.de
authors.forename: J
authors.initials: J
authors.lastname: Müller-Nordhorn
authors.forename: B
authors.initials: B
authors.lastname: Brüggenjürgen
authors.forename: M
authors.initials: M
authors.lastname: Böhmig
authors.forename: D
authors.initials: D
authors.lastname: Selim
authors.forename: A
authors.initials: A
authors.lastname: Reich
authors.forename: L
authors.initials: L
authors.lastname: Noesselt
authors.forename: S
authors.initials: S
authors.lastname: Roll
authors.forename: B
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: S N
authors.initials: SN
authors.lastname: Willich
mesh_terms: D000041:Absenteeism; D000553:Ambulatory Care / Q000191:economics; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D004180:Direct Service Costs; D004651:Employment; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D016019:Survival Analysis