title: The cost and burden of cancer in the European Union 1995-2014.
abstract: There is an intense debate about the cost of cancer and the value of new treatments. However, there is limited data on the cost of cancer in the European Union (EU) and how costs relate to the burden of disease. This paper presents new estimates on the development of the cost of cancer in the EU 1995-2014, with a focus on the major cost components: total health expenditure, cancer drugs, and production loss due to premature mortality.
  
  
  
  Data on overall health expenditure were combined with national disease estimates to derive cancer-specific health expenditure. Data on drug sales were obtained from IMS Health, and epidemiological data were used to calculate life years lost due to cancer.
  
  
  
  Health expenditure on cancer increased continuously from €35.7 billion in 1995 to €83.2 billion in 2014 in the EU and spending on cancer drugs from €7.6 billion in 2005 to €19.1 billion in 2014 (current prices). Yet the share of total health expenditure devoted to cancer was mostly constant (around 6 per cent). While expenditures on cancer drugs increased in both absolute and relative terms, other expenditures were stable or decreased, despite increases in cancer incidence driven by a growing and ageing population. Reductions in cancer mortality during working age resulted in decreasing production loss due to premature mortality.
  
  
  
  Health spending on cancer as a share of total health expenditure is rather low and stable despite the growing incidence and relative burden of cancer. Problems to reallocate funding in health care systems under economic pressure may be one explanation and shifting costs from inpatient to ambulatory care another.
authors: Stockholm School of Economics, Department of Economics, Stockholm, Sweden. Electronic address: bengt.jonsson@hhs.se.
authors: Bengt
authors: B
authors: Jönsson
authors: Lund University, Department of Economics, Lund, Sweden. Electronic address: thomas.hofmarcher@nek.lu.se.
authors: Thomas
authors: T
authors: Hofmarcher
authors: IHE, The Swedish Institute for Health Economics, Lund, Sweden. Electronic address: peter.lindgren@ihe.se.
authors: Peter
authors: P
authors: Lindgren
authors: Karolinska Institutet, Stockholm, Sweden. Electronic address: nils.wilking@skane.se.
authors: Nils
authors: N
authors: Wilking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D016527:Drug Costs; D017598:Efficiency, Organizational / Q000191:economics / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005062:European Union / Q000191:economics; D005102:Health Expenditures; D006801:Humans; D008875:Middle Aged; D061213:Mortality, Premature; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Cost of cancer drugs; Direct costs; EU; Indirect costs; National expenditures on cancer