Cost of care for lung cancer in the first year after diagnosis in Iran.

Objective: The aim of this study was to estimate the cost of lung cancer treatment in the first year after diagnosis in Iran.

Materials And Methods: Patients from two referral hospitals providing all lines of treatment to cancer patients in Tehran were sampled. The direct cost included the costs that patients and other payer' s (insurance, NGO's, or other source of payment services) paid for the services received since their first confirmed diagnosis of cancer for the duration of one year. Nine items of services were evaluated for each case with exact costs abstracted from patient's files. Using incidence of lung cancer and population figure of the country, total number of lung cancer was estimated. The total and itemized costs were estimated using an average per patients for each service.

Results: The average age at diagnosis was around 56 years and majority of cases were male. All patients were insured by major insurance companies. A total of 5,829 cases of lung cancer were estimated to occur in 2010. The average±standard deviation (sd) of duration of hospital stay was 11.9±9.7 days. Not all the patients received all lines of services: 86% received surgery, 36% radiotherapy; and 45% chemotherapy in the first year. Some 14% of cases utilized physiotherapy and 11.5% needed pre-treatment counseling. The grand total cost of treatment for the first year of services since diagnosis was estimated at 11,262,386 US dollars for the whole population of Iran in the year 2010. Among different services provided to the patients, surgery with annual cost of 3,178,725 US dollars constitute 28% of the total cost; radiotherapy and cost of paid for medication with an annual cost of 4,242,244 US dollars accounted for 38% of total costs. With 7.8% of Iranian GDP being consumed in health expenditure, the direct cost of lung cancer for the first year after diagnosis amounted to 4% of this figure.

Conclusion: Our study, the first to estimate the direct cost of lung cancer in Iran, indicate how costly lung cancer is to the country. More comprehensive studies are needed to validate our results plus to assess other cost including indirect costs.