The Direct and Indirect Costs of Colorectal Cancer in Vietnam: An Economic Analysis from a Social Perspective
Abstract
:1. Introduction
New Contribution
2. Materials and Methods
2.1. Study Design and Setting
2.1.1. Study Design
Direct Cost
Indirect Cost
- FIL = future income loss;
- i = sex;
- j = age;
- t = age at death;
- k = 1, 2,…., n (k is the difference between the age at death and the life expectancy of the age cohort);
- D = number of deaths;
- YW = yearly wage by i and j;
- E = employment rates by i and j;
- r = discount rate.
- PL = productivity loss;
- i = sex;
- j = age;
- IV = number of patient visits (combination of inpatient and outpatient visits);
- E = employment rates;
- DW = daily wage.
2.2. Data Analysis
2.3. Ethical Considerations
3. Results
4. Discussion
Limitation
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries R. CA Cancer J. Clin. 2018, 68, 394–424. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Arnold, M.; Sierra, M.S.; Laversanne, M.; Soerjomataram, I.; Jemal, A.; Bray, F.J.G. Global patterns and trends in colorectal cancer incidence and mortality. Gut 2017, 66, 683–691. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Nguyen, S.M.; Deppen, S.; Nguyen, G.H.; Pham, D.X.; Bui, T.D.; Tran, T.V. Projecting Cancer Incidence for 2025 in the 2 Largest Populated Cities in Vietnam. Cancer Control 2019, 26. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Pham, T.; Bui, L.; Kim, G.; Hoang, D.; Tran, T.; Hoang, M. Cancers in Vietnam-Burden and Control Efforts: A Narrative Scoping Review. Cancer Control 2019, 26. [Google Scholar] [CrossRef]
- ACTION Study Group. Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: Results from a longitudinal study in eight countries. BMC Med. 2015, 13, 190. [Google Scholar] [CrossRef][Green Version]
- Van Minh, H.; Pham, C.P.; Mai, V.Q.; Ngo, T.T.; Tran, D.H.; Bui, D.; Pham, X.D.; Tran, D.K.; Mai, T.K. Household financial burden and poverty impacts of cancer treatment in Vietnam. Biomed Res. Int. 2017, 2017, 1–8. [Google Scholar]
- Kimman, M.; Jan, S.; Kingston, D.; Monaghan, H.; Sokha, E.; Thabrany, H.; Bounxouei, B.; Bhoo-Pathy, N.; Khin, M.; Cristal-Luna, G.; et al. Socioeconomic Impact of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN): The ACTION Study Protocol. Asian Pac. J. Cancer Prev. 2012, 13, 421–425. [Google Scholar] [CrossRef][Green Version]
- World Health Organization. Global Health Expenditure Database: Vietnam 2019. Available online: https://apps.who.int/nha/database/ViewData/Indicators/en (accessed on 1 June 2020).
- Hue Central Hospital. Hue Central Hospital 2019. Available online: http://bvtwhue.com.vn/Home/Index/?lang=eng (accessed on 1 April 2020).
- Ferlay, J.; Ervik, M.; Lam, F.; Colombet, M.; Mery, L.; Piñeros, M.; Znaor, A.; Soerjomataram, I.; Bray, F. Global Cancer Observatory: Cancer Today; International Agency for Research on Cancer: Lyon, France, 2018. [Google Scholar]
- Ferlay, J.; Colombet, M.; Soerjomataram, I.; Mathers, C.; Parkin, D.M.; Piñeros, M.; Znaor, A.; Bray, F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int. J. Cancer 2019, 144, 1941–1953. [Google Scholar] [CrossRef][Green Version]
- Jo, C. Cost-of-illness studies: Concepts, scopes, and methods. Clin. Mol. Hepatol. 2014, 20, 327–337. [Google Scholar] [CrossRef]
- General Statistics Office of Vietnam. National Report on Labor Force Survey Quarter II of 2018; General Statistics Office of Vietnam: Hanoi, Vietnam, 2018. [Google Scholar]
- General Statistics Office of Vietnam. Main Results on Survey of Population Change and Family Planning as of April 1, 2017; General Statistics Office: Hanoi, Vietnam, 2018. [Google Scholar]
- World Health Organization. Vietnam Health Statistics 2016. Available online: https://www.who.int/countries/vnm/en/ (accessed on 15 September 2020).
- General Statistics Office of Vietnam. Statitiscal Summary Book of Vietnam 2018; General Statistics Office: Hanoi, Vietnam, 2018. [Google Scholar]
- Robinson, L.A.; Hammitt, J.K.; Cecchini, M.; Chalkidou, K.; Claxton, K.; Cropper, M.; Eozenou, P.H.V.; de Ferranti, D.; Deolalikar, A.B.; Guanais, F.; et al. Reference Case Guidelines for Benefit-Cost Analysis in Global Health and Development; Harvard University: Cambridge, MA, USA, 2019. [Google Scholar]
- Hoang Anh, P.T.; Thu le, T.; Ross, H.; Quynh Anh, N.; Linh, B.N.; Minh, N.T. Direct and indirect costs of smoking in Vietnam. Tob. Control 2016, 25, 96–100. [Google Scholar] [CrossRef][Green Version]
- Vahdatimanesh, Z.; Zendehdel, K.; Akbari-Sari, A.; Farhan, F.; Nahvijou, A.; Delavari, A.; Daroudi, R. Economic burden of colorectal cancer in Iran in 2012. Med. J. Islam Rep. Iran. 2017, 31, 115. [Google Scholar] [CrossRef] [PubMed]
- Byun, J.Y.; Yoon, S.J.; Oh, I.H.; Kim, Y.A.; Seo, H.Y.; Lee, Y.H. Economic burden of colorectal cancer in Korea. J. Prev. Med. Public Health 2014, 47, 84–93. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Yabroff, K.R.; Borowski, L.; Lipscomb, J. Economic Studies in Colorectal Cancer: Challenges in Measuring and Comparing Costs. JNCI Monogr. 2013, 2013, 62–78. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Le, N.Q.; Vo, T.Q.; Doan, T.D. Analyzing the variation in treatment costs for colorectal cancer (CRC): A retrospective study to assess an underlying threat among the Vietnamese. J. Pak. Med. Assoc 2019, 69 (Suppl. 2), S34–S40. [Google Scholar]
- Azzani, M.; Yahya, A.; Roslani, A.C.; Su, T.T. Catastrophic Health Expenditure Among Colorectal Cancer Patients and Families: A Case of Malaysia. Asia Pac. J. Public Health 2017, 29, 485–494. [Google Scholar] [CrossRef] [PubMed]
- Huang, H.-Y.; Shi, J.; Guo, L.; Bai, Y.; Liao, X.; Liu, G.-X.; Mao, A.-Y.; Ren, J.; Sun, X.; Zhu, X.-Y.; et al. Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: A hospital-based, multicenter, cross-sectional survey. Chin. J. Cancer 2017, 36, 1–15. [Google Scholar] [CrossRef][Green Version]
- Dunn, J.P. The economic burden of colorectal cancer in New Zealand. N. Z. Med. J. 2015, 128, 100. [Google Scholar]
- Hoang Lan, N.; Laohasiriwong, W.; Stewart, J.F.; Tung, N.D.; Coyte, P.C. Cost of treatment for breast cancer in central Vietnam. Glob Health Action 2013, 6, 18872. [Google Scholar] [CrossRef]
- Van Minh, H.; My, N.T.T.; Jit, M. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: A PRIME modeling study. BMC Health Serv. Res. 2017, 17, 353. [Google Scholar] [CrossRef][Green Version]
- World Health Organization. Health Financing in Viet Nam. Available online: https://www.who.int/vietnam/ (accessed on 1 April 2020).
- Vietnam Health Insurance Agency. Decree 62/2009/NĐ-CP: Detailed Regulations and Implementation Guidelines of Articles Related to the Vietnam Law on Health Insurance. Available online: http://vanban.chinhphu.vn/portal/page/portal/chinhphu/hethongvanban?class_id=1&mode=detail&document_id=89474 (accessed on 15 June 2020).
- ACTION Study Group. Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study. Eur. J. Cancer 2017, 74, 26–37. [Google Scholar] [CrossRef]
- ACTION Study Group. Financial catastrophe, treatment discontinuation and death associated with surgically operable cancer in South-East Asia: Results from the ACTION Study. Surgery 2015, 157, 971–982. [Google Scholar] [CrossRef]
- Nguyen, T.X.T.; Han, M.; Oh, J.-K. The economic burden of cancers attributable to smoking in Korea, 2014. Tob. Induc. Dis. 2019, 15. [Google Scholar] [CrossRef] [PubMed]
- Mar, J.; Errasti, J.; Soto-Gordoa, M.; Mar-Barrutia, G.; Martinez-Llorente, J.M.; Domínguez, S.; et al. The cost of colorectal cancer according to the TNM stage. Cirugía Española 2017, 95, 89–96. [Google Scholar] [CrossRef]
- Sung, J.J.Y.; Chiu, H.-M.; Jung, K.-W.; Jun, J.K.; Sekiguchi, M.; Matsuda, T.; et al. Increasing Trend in Young-Onset Colorectal Cancer in Asia: More Cancers in Men and More Rectal Cancers. Am. J. Gastroenterol. 2019, 114, 322–329. [Google Scholar] [CrossRef] [PubMed]
- Quach, D.T.; Nguyen, O.T. Clinical, endoscopic and pathogical characteristics of early-onset colorectal cancer in Vietnamese. Asian Pac. J. Cancer Prev. 2012, 13, 1767–1770. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Zhang, J.; Cheng, Z.; Ma, Y.; He, C.; Lu, Y.; Zhao, Y.; Chang, X.; Zhang, Y.; Bai, Y.; Cheng, N. Effectiveness of Screening Modalities in Colorectal Cancer: A Network Meta-Analysis. Clin. Colorectal Cancer 2017, 16, 252–263. [Google Scholar] [CrossRef]
- Sheerin, I.; Green, T.; Sarfati, D.; Cox, B. Projected costs of colorectal cancer treatment in New Zealand in the absence of population screening. N. Z. Med. J. 2015, 128, 72–85. [Google Scholar]
Average Medical Cost per Patient (1000 VND, Estimated from 531 Patients, 1698 Claims) | Number of CRC Patient in Vietnam (GLOBOCAN) | Total Medical Cost | |||||
---|---|---|---|---|---|---|---|
Variables | C18 | C20 | C19 | All | Million VND | USD ($ 1) | |
All (n) | 268 | 256 | 7 | 531 | |||
Total cost * | 41,008 | 47,594 | 30,656 | 43,277 | 9481 | 410,313,103 | 17,933,265 |
Insurer (96.8%)* | 37,673 | 44,308 | 29,050 | 40,758 | |||
Gender * | |||||||
Male | 42,687 | 52,396 | 30,826 | 46,492 | 4857 | 225,812,313 | 9,869,419 |
Female | 38,740 | 40,461 | 30,528 | 39,900 | 4624 | 184,500,789 | 8,063,845 |
Age * (%) | |||||||
<30 (3.2) | 41,211 | 71,868 | NA | 50,228 | 184 | 9,859,937 | 430,941 |
30–39 (7.7) | 56,404 | 55,146 | NA | 55,852 | 364 | 20,947,267 | 915,527 |
40–49 (12.1) | 52,586 | 51,009 | NA | 51,822 | 1235 | 64,590,778 | 2,823,024 |
50–59 (27.9) | 44,534 | 52,835 | 10,315 | 48,615 | 2529 | 122,163,179 | 5,339,300 |
60–69 (26.0) | 38,304 | 49,544 | 28,166 | 42,881 | 2644 | 115,622,800 | 5,053,444 |
70+ (23.2) | 28,723 | 34,308 | NA | 31,338 | 2525 | 77,129,143 | 3,371,029 |
Average cost (CRC stages)* | |||||||
I (6.6%) | 19,696 | 19,406 | 246,300 | 18,974 | |||
II (23.2%) | 37,687 | 43,033 | 69,066 | 40,767 | |||
III (33.9%) | 48,507 | 52,308 | 13,775 | 49,934 | |||
IV (28.8%) | 47,433 | 62,704 | 51,978 | 53,581 | |||
NA (7.5%) | 12,794 | 13,645 | NA | 13,113 |
Average Cost—Estimated from 531 Patients | Number of CRC Patient in Vietnam (GLOBOCAN) | Total Non-Medical Cost | ||||||
---|---|---|---|---|---|---|---|---|
Cost by Gender | No of patients | Transportation | Food-Patients | Food-Caregiver | Cost per Patient VND (USD) | VND (1000) | US ($ 1) | |
All | 120 | 487 | 5334 | 3256 | 9561 (411) | 9481 | 89,201,728 | 3,898,677 |
Male | 67 | 302 | 5422 | 3302 | 9328 (407) | 4857 | 45,306,096 | 1,980,162 |
Female | 53 | 537 | 5223 | 3197 | 9493 (415) | 4624 | 43,895,632 | 1,918,515 |
Gender | Age Groups | Number of CRC in Vietnam (GLOBOCAN) | Total indirect Cost | |||||
---|---|---|---|---|---|---|---|---|
<30 | 30–39 | 40–49 | 50–59 | 60+ | Total(VND) | US $ | ||
Productivity loss due to cancer care | Prevalent cases | |||||||
Male | 619.5 | 1854.5 | 7777.7 | 8328.1 | 2328 | 18,579.8 | 812,056 | |
Female | 770.4 | 1469.7 | 3226.3 | 5557.9 | 1985 | 11,024.3 | 481,830 | |
All | 1389.8 | 3324.3 | 11,004.0 | 13,885.9 | 4313 | 29,604.1 | 1,293,886 | |
Future income loss due to premature deaths | Death cases | |||||||
Male | 11,649.4 | 109,365.7 | 369,649.9 | 611,940.3 | 276,625.1 | 2492 | 1,379,230.5 | 60,281,052 |
Female | 8236.7 | 82,466.9 | 246,792.9 | 405,467.2 | 390,571.1 | 2438 | 1,133,534.9 | 49,542,611 |
All | 19,886.2 | 191,832.7 | 616,442.8 | 1,017,407.5 | 667,196.2 | 4930 | 2,512,765.4 | 109,823,664 |
The total of indirect cost | ||||||||
Male | 12,268.9 | 111,220.4 | 377,427.6 | 620,268.4 | 276,625.1 | 1,397,810.3 | 61,093,109 | |
Female | 9007.1 | 83,936.7 | 250,019.2 | 411,025.0 | 390,571.1 | 1,144,559.2 | 50,024,441 | |
All | 21,276.1 | 195,157.0 | 627,446.8 | 1,031,293.5 | 667,196.2 | 2,542,369.5 | 111,117,550 |
Cost Components | Male | Female | All (VND) | US $ | Percentage |
---|---|---|---|---|---|
Direct cost | 271,118.4 | 228,396.4 | 499,514.8 | 21,831,942 | 16.42% |
Medical cost | 225,812.3 | 184,500.7 | 410,313.1 | 17,933,265 | 13.49% |
Non-medical cost | 45,306.1 | 43,895.6 | 89,201.7 | 3,898,677 | 2.93% |
Indirect cost | 1,397,810.3 | 1,144,559.2 | 2,542,369.5 | 111,117,550 | 83.58% |
Future income loss | 1,379,230.4 | 1,133,534.9 | 2,512,765.4 | 109,823,664 | 82.61% |
Productivity loss | 18,579.8 | 11,024.2 | 29,604.1 | 1,293,886 | 0.97% |
Total | 1,668,928.7 | 1,372,955.6 | 3,041,884.4 | 132,949,492 | 0.055%~ GDP |
$ US | 72,942,689.37 | 60,006,802.32 |
Costs | 0% | 3% (base) | 5% |
---|---|---|---|
Indirect cost (million VND) | 5,520,336.9 | 2,542,369.5 | 1,609,748.3 |
Total cost (million VND) | 6,019,851.7 | 3,041,884.3 | 2,109,263.1 |
USD | 263,105,409 | 132,949,492 | 92,188,075 |
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Tran, B.T.; Choi, K.S.; Nguyen, T.X.; Sohn, D.K.; Kim, S.-Y.; Suh, J.K.; Phan, V.S.; Pham, H.T.; Nguyen, M.H.; Nguyen, T.B.; Hoang, H.K.; Nguyen, T.T.B.; Nguyen, M.T.; Oh, J.-K. The Direct and Indirect Costs of Colorectal Cancer in Vietnam: An Economic Analysis from a Social Perspective. Int. J. Environ. Res. Public Health 2021, 18, 12. https://doi.org/10.3390/ijerph18010012
Tran BT, Choi KS, Nguyen TX, Sohn DK, Kim S-Y, Suh JK, Phan VS, Pham HT, Nguyen MH, Nguyen TB, Hoang HK, Nguyen TTB, Nguyen MT, Oh J-K. The Direct and Indirect Costs of Colorectal Cancer in Vietnam: An Economic Analysis from a Social Perspective. International Journal of Environmental Research and Public Health. 2021; 18(1):12. https://doi.org/10.3390/ijerph18010012
Chicago/Turabian StyleTran, Binh Thang, Kui Son Choi, Thanh Xuan Nguyen, Dae Kyung Sohn, Sun-Young Kim, Jae Kyung Suh, Van Sang Phan, Huu Tri Pham, Minh Hanh Nguyen, Thanh Binh Nguyen, Huu Khoi Hoang, Thi Thanh Binh Nguyen, Minh Tu Nguyen, and Jin-Kyoung Oh. 2021. "The Direct and Indirect Costs of Colorectal Cancer in Vietnam: An Economic Analysis from a Social Perspective" International Journal of Environmental Research and Public Health 18, no. 1: 12. https://doi.org/10.3390/ijerph18010012