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Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity

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A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 4840

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Editor

Dr. Marcell Csanádi

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Guest Editor

Syreon Research Institute, 1142 Budapest, Hungary
Interests: health economics; cost-effectiveness analysis; economic evaluation; health care management; health outcomes; cost estimation

Special Issue Information

Dear Colleagues,

Recent advances in cancer prevention, diagnosis, and treatment have improved survival rates. However, these improvements have also led to rising costs that burden patients, families, and health systems. Financial toxicity is now recognized as a serious consequence of cancer care, affecting patients’ quality of life, treatment adherence, and long-term outcomes, even in countries with universal health coverage. This Special Issue welcomes original research and reviews on the economic aspects of oncology, including cost-effectiveness, financial disparities, value-based care, and policy strategies that improve affordability and equity. We are especially interested in studies that explore ways to reduce financial hardship, increase efficiency, and support informed decision-making throughout the process of cancer care. We also welcome the submission of articles that focus on underserved populations and global trends such as digital health tools or workforce-related policies. We aim to generate actionable insights that support both economic sustainability and improved patient outcomes in oncology.

Dr. Marcell Csanádi
Guest Editor

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Keywords

financial toxicity
cost-effectiveness
value-based care
cancer care
economic sustainability
health policy
treatment affordability
underserved populations
digital health
oncology economics

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Published Papers (4 papers)

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Research

13 pages, 352 KB

Open AccessArticle

Stage-Specific Healthcare Costs in Cervical Cancer and Cervical Intraepithelial Neoplasia: A Population-Based Analysis Informing Value-Based Oncology and Equitable Prevention

by Tian-Shyug Lee and Yu-Chiao Wang

Curr. Oncol. 2026, 33(6), 329; https://doi.org/10.3390/curroncol33060329 - 1 Jun 2026

Viewed by 643

Abstract

Persistent challenges in cervical cancer (CC) control highlight the need for stage-specific cost estimates to refine prevention strategies. Structural integration of National Health Insurance (NHI) administrative claims, the Taiwan Cancer Registry (TCR), and the National Cause of Death Registry (NCDR) provided the empirical basis for this population-based research. The final analytical sample encompassed 6055 women with cervical intraepithelial neoplasia (CIN) identified in 2016 as well as 9318 patients diagnosed with stage I to IV invasive CC during the 2008 to 2015 period. Reimbursed direct medical costs were estimated for CIN within 6 months after diagnosis and for CC over 5 years after diagnosis. Across CIN grades, no consistent cost gradient was observed, although inpatient utilization was highest in CIN3. Among women with CC, healthcare utilization and expenditures were concentrated in the first year after diagnosis, accounting for 52–65% of the total 5-year costs. After age adjustment, the mean first-year costs increased from NT$256,095 (US$8413) in stage I to NT$474,724 (US$15,595) in stage IV, while 5-year survival declined from 85.3% to 19.5%. These findings show that cervical disease imposes substantial direct medical costs on Taiwan’s healthcare system and provide updated evidence to inform human papillomavirus (HPV) vaccination and CC screening policy. Full article

(This article belongs to the Special Issue Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity)

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14 pages, 275 KB

Open AccessArticle

Cost-Effectiveness of Radiotherapy and Its Impact on Patient Quality of Life: A Real-World Cost Utility Analysis in Greece

by Elissavet Vardaki, Maria Tolia, Christos Michalakelis and Athanassios Vozikis

Curr. Oncol. 2026, 33(4), 220; https://doi.org/10.3390/curroncol33040220 - 16 Apr 2026

Viewed by 1238

Abstract

Background: The aim of this study was to estimate the economic burden of radiotherapy (RT) from the perspectives of payers, the healthcare system, patients, and society, and to assess associated quality-of-life (QoL) outcomes. The analysis examined direct medical and non-medical costs, as well as QoL, before, during, and up to six months after RT. Given the inclusion of multiple cancer types, the study reflects a heterogeneous real-world population. An exploratory comparison across RT techniques was also conducted to provide contextual economic insight. Methods: This analysis included data from 301 cancer patients undergoing RT using various techniques, including two-dimensional radiotherapy (2D), 3D conformal radiotherapy (3D-CRT), volumetric-modulated arc therapy (VMAT), and intensity-modulated radiotherapy (IMRT), at the University General Hospital of Heraklion, Crete, Greece. Clinical and cost data were collected retrospectively, while QoL data were collected prospectively using validated instruments at baseline, end of treatment, and six months post-treatment. Quality-adjusted life years (QALYs) were estimated. The primary analysis compared RT with a hypothetical “no RT” comparator derived from published evidence, while comparisons across RT techniques were conducted as exploratory analyses. Costs and QALYs were evaluated over a 6-month time horizon; therefore, discounting was not applied. Incremental cost-effectiveness ratios (ICERs) were calculated, and probabilistic sensitivity analysis was performed to account for parameter uncertainty. Results: The cost per QALY gained with RT compared with the hypothetical “no RT” comparator varied substantially across techniques and cancer types. In the primary analysis, 2D radiotherapy yielded the lowest ICER (€13,043.27/QALY), while VMAT demonstrated an ICER of €29,945.12/QALY. In contrast, IMRT was associated with a substantially higher ICER (€135,529.51/QALY), suggesting limited cost-effectiveness under commonly accepted willingness-to-pay thresholds, whereas 3D-CRT was found to be dominant. Subgroup analyses revealed marked heterogeneity, with ICERs ranging from €3234.45 to €30,232.50 per QALY gained across cancer types. In certain subgroups, RT was either cost-saving or dominant, particularly in breast cancer (cost-saving with similar QALYs) and in skin cancer and sarcoma (dominant strategies). Sensitivity analyses highlighted considerable uncertainty, especially for 2D radiotherapy, primarily driven by small sample sizes and variability in QALY estimates. Conclusions: This study provides short-term, real-world evidence on the cost-effectiveness and quality-of-life outcomes of radiotherapy in a Greek healthcare setting. While simpler techniques such as 2D radiotherapy may appear economically favorable, their limited effectiveness and substantial uncertainty may reduce their overall value. In contrast, advanced techniques—particularly VMAT—demonstrate a more consistent balance between cost and clinical outcomes, supporting their role within value-based, patient-centered oncology care. However, the findings should be interpreted with caution due to population heterogeneity, small subgroup sizes, the short (6-month) time horizon, and the use of a hypothetical comparator. Further research with longer follow-up and disease-specific analyses is warranted. Full article

(This article belongs to the Special Issue Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity)

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15 pages, 493 KB

Open AccessArticle

Assessing Training Practices and Gaps for Staff Involved in the Delivery of Oncology Financial Navigation: A Qualitative Study

by Gaby Cordero, Maria Pisu, Shu-Fan Chen, Elizabeth Ward and Margaret I. Liang

Curr. Oncol. 2026, 33(2), 130; https://doi.org/10.3390/curroncol33020130 - 23 Feb 2026

Viewed by 650

Abstract

Financial hardship affects 30–70% of cancer patients and is associated with worse quality-of-life outcomes and higher mortality. In response, many health systems have implemented financial navigation teams to mitigate financial hardship and provide financial guidance to cancer patients. Currently, there is a lack of standardization in financial navigation training. Our primary objective was to assess current training practices and gaps that may exist in critical information and tools for day-to-day operations for individuals providing financial navigation services. Our secondary objective was to supplement findings from the interviews with a web-based search for training resources that would be helpful in these roles. Semi-structured qualitative interviews were conducted over a video-based conferencing platform in the United States of America with nine individuals in varying roles related to financial navigation. Thematic analysis was conducted by investigators to identify common themes using a constant comparative method. Current financial navigation training practices were found to be less structured and comprehensive than desired, largely relying on experiential “on the job” learning. Participants expressed the need for more multi-dimensional training that covers insurance, cancer treatment and associated costs, financial resources, and an emphasis on developing soft skills to navigate the sensitive topics of cancer and cancer costs. The findings contribute to the development of more standardized trainings that incorporate dissemination of crucial financial information in a compassionate manner. A web-based search was also performed to create a compilation of available financial navigation training resources. Full article

(This article belongs to the Special Issue Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity)

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16 pages, 1496 KB

Open AccessArticle

Cost-Effectiveness of Positron Emission Tomography/Computed Tomography (PET/CT) in the Initial N-Staging of Head–Neck Cancer and Comparison with CT and Magnetic Resonance Imaging (MRI)

by Nikolaos Papathanasiou, Maria Spiliotopoulou, Eleni Karagkouni, Dimitrios Apostolopoulos, Paraskevi Katsakiori, John Yfantopoulos and Nikolaos Kotsopoulos

Curr. Oncol. 2025, 32(12), 677; https://doi.org/10.3390/curroncol32120677 - 1 Dec 2025

Viewed by 1551

Abstract

The aim of the study was to evaluate the cost-effectiveness of PET/CT in the initial N-staging of head–neck cancer (HNC) and to compare it with alternative strategies using CT or MRI within the Greek National Healthcare System. A cohort of 100 clinically N0 (with no apparent metastatic cervical lymph nodes) HNC patients was simulated over a 10-year time horizon. Initially, a decision tree model was used to simulate the following three different imaging strategies for HNC staging: (a) whole-body FDG-PET/CT, (b) CT of the neck, chest, and abdomen (“CT”), and (c) MRI of the neck plus CT of the chest–abdomen (“MRI”). Subsequently, a Markov model was used to simulate transitions into the health states of recurrence and death. Epidemiological evidence, diagnostic accuracy rates, transition probabilities, and healthcare costs were obtained from the literature and official local tariffs. The estimated total costs per patient were EUR 128,729 for PET/CT, EUR 128,779 for MRI, and EUR 128,585 for CT. The corresponding life years (LYs) were 6.171 LYs for PET/CT, 6.170 LYs for MRI, and 6.170 LYs for CT, respectively. The analysis showed that PET/CT dominates MRI. The incremental cost-effectiveness ratio (ICER) of PET/CT vs. CT was estimated at EUR 144,984 per LY gained. All three imaging strategies had comparable health outcomes and costs, with PET/CT being an appropriate and efficient imaging modality because of its high diagnostic accuracy in the N-staging of HNC. Full article

(This article belongs to the Special Issue Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity)

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