title: Long-term costs of colorectal cancer treatment in Spain.
abstract: BACKGROUND
  Assessing the long-term cost of colorectal cancer (CRC) increases our understanding of the disease burden. The aim of this paper is to estimate the long-term costs of CRC care by stage at diagnosis and phase of care in the Spanish National Health Service.
  
  
  METHODS
  Retrospective study on resource use and direct medical cost of a cohort of 699 patients diagnosed and treated for CRC in 2000-2006, with follow-up until 30 June 2011, at Hospital del Mar (Barcelona). The Kaplan-Meier sample average estimator was used to calculate observed 11-year costs, which were then extrapolated to 16 years. Bootstrap percentile confidence intervals were calculated for the mean long-term cost per patient by stage. Phase-specific, long-term costs for the entire CRC cohort were also estimated.
  
  
  RESULTS
  With regard to stage at diagnosis, the mean long-term cost per patient ranged from €20,708 (in situ) to €47,681 (stage III). The estimated costs increased at more advanced stages up to stage III and then substantially decreased in stage IV. In terms of treatment phase, the mean cost of the initial period represented 24.8 % of the total mean long-term cost, whereas the cost of continuing and advanced care phases represented 16.9 and 58.3 %, respectively.
  
  
  CONCLUSIONS
  This study is the first to provide long-term cost estimates for CRC treatment, by stage at diagnosis and phase of care, based on data from clinical practice in Spain, and it will contribute useful information for future studies on cost-effectiveness and budget impact of different therapeutic innovations in Spain.
authors.affiliation: Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Doctoral Programme in Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain. jcorral@iconcologia.net.|Department of Health, Catalonian Cancer Strategy, Generalitat de Catalunya, Barcelona, Spain. jcorral@iconcologia.net.
authors.forename: Julieta
authors.initials: J
authors.lastname: Corral
authors.affiliation: IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.|Health Services Research on Chronic Patients Network (REDISSEC), Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Castells
authors.affiliation: Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Molins
authors.affiliation: IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Pietro
authors.initials: P
authors.lastname: Chiarello
authors.affiliation: Department of Health, Catalonian Cancer Strategy, Generalitat de Catalunya, Barcelona, Spain.|Department of Clinical Sciences, Bellvitge Biomedical Research Institute (IDIBELL), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Borras
authors.affiliation: IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.|Health Services Research on Chronic Patients Network (REDISSEC), Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Cots
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care / Q000191:economics; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D013030:Spain