[Cost of cancer in France: pharmaceutical expenditure as part of global patients' care].
The INCa, as well as the French National Health Insurance recently published, and for the first time, important reports making it possible to take stock of the cost of care for the patients treated for a cancer or a malignant hemopathy, and in particular on the pharmaceutical expenditure related to cancer. The number of people with full medical coverage ("ALD") for cancer increased by 62% in 10 years, and exceeds 1.25 million people today. The corresponding expenditure is close to 14 billions euros for public health insurance systems, appreciably lower than that related to the cardiovascular diseases. The annual expenditure by patient treated for cancer is much lower than that related on the chronic renal failure, transplantations or the VIH-AIDS. The share of the expenditure related to the medical drugs and other goods (devices) is estimated by the INCa at 13% of the total expenditure related to the care. The anti-cancer drugs count for 20% of the pharmaceutical expenditure of the hospitals, of which the half related to specialities reimbursed in addition to the "T2A" fixed rates. Due primarily to the new anti-cancer drugs, the expenditure for this class increased by more than 6 fold in 10 years, responsible for 37% of the total increase in hospital health care expenditure. However, the share of the expenditure related to the drugs is lower for the patients treated in "ALD" for cancer than that of the whole of the ALD (19.5 vs 20%). For the Health insurance, the cost for anticancer drugs, all classes and indications included, accounts for 2.1% of the expenses, i.e. 1.5% of the national current health expenditure. The innovating anti-cancer drugs count for less than 4% of the expenditure related to cancer, i.e. less than 0.45% of the total expenditure. It is necessary to consider these data, correlatively to the clinical and social benefit gained, in the strategies of care.
Service de médecine interne, hôpital Bichat, Paris, France. jean-jacques.zambrowski@univ-paris5.fr
Jean-Jacques
JJ
Zambrowski
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D005602:France / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology