Estimated Direct Costs of Renal Cancer by Stage of Disease at Diagnosis and Phase of Its Management: A Whole-Disease Model.

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Clinical Guidelines
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Buja A, De Luca G, Gatti M, Bonaldi F, Gardi M, Bortolami A, Sepulcri M, Bimbatti D, Baldo V, Scioni M, Maruzzo M, Basso U, Zagonel V
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Oncology
Urology & Nephrology
Immunology Allergy & Inflammation
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Immunology Allergy & Inflammation
Oncology
Urology & Nephrology
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volume
21
ISSN
1938-0682
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1938-0682
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["Buja A, De Luca G, Gatti M, Bonaldi F, Gardi M, Bortolami A, Sepulcri M, Bimbatti D, Baldo V, Scioni M, Maruzzo M, Basso U, Zagonel V","For IRENE Investigators","Publisher: Elsevier Country of Publication: United States NLM ID: 101260955 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-0682 (Electronic) Linking ISSN: 15587673 NLM ISO Abbreviation: Clin Genitourin Cancer Subsets: MEDLINE","Journal Article","2023-08-01","Clinical genitourinary cancer [Clin Genitourin Cancer] 2023 Aug; Vol. 21 (4), pp. e252-e260. Date of Electronic Publication: 2023 Feb 09.","English","1938-0682","Carcinoma, Renal Cell*\/therapy , Carcinoma, Renal Cell*\/drug therapy , Kidney Neoplasms*\/drug therapy, Humans ; Health Care Costs ; Italy","Humans, Health Care Costs, Italy, Carcinoma, Renal Cell therapy, Carcinoma, Renal Cell drug therapy, Kidney Neoplasms drug therapy","Clinical genitourinary cancer","21"]
Description
Background: Renal cell carcinoma (RCC) is the seventh most common neoplasm in high-income countries. New clinical pathways have been developed to deal with this tumor, which includes costly drugs that pose an economic threat to the sustainability of healthcare services. This study provides an estimate of the direct costs of care for patients with RCC by stage of disease (early vs. advanced) at diagnosis, and disease management phase along the pathway recommended by local and international guidelines.<br />Materials and Methods: Considering the clinical pathway for RCC adopted in the Veneto region (north-east Italy) and the latest guidelines, we developed a very detailed "whole-disease" model that covers the probabilities of all potentially necessary diagnostic and therapeutic actions involved in the management of RCC. Based on the cost of each procedure according to the Veneto Regional Authority's official reimbursement tariffs, we estimated the total and average per-patient costs by stage of disease (early or advanced) and phase of its management.<br />Results: In the first year after diagnosis, the mean expected cost of a patient with RCC is €12,991 if it is localized or locally-advanced and reaches €40,586 if it is advanced. For early disease, the main cost is incurred by surgery, whereas medical therapy (first and second line) and supportive care become increasingly important for metastatic disease.<br />Conclusion: It is crucially important to examine the direct costs of care for RCC, and to predict the burden on healthcare services of new oncological therapies and treatments, as the findings could be useful for policy-makers planning the allocation of resources.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
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