Population-level economic burden of lung cancer in China: Provisional prevalence-based estimations, 2017 - 2030

Abstract

Objective: Population-level economic burden is essential for prioritizing healthcare resources and healthcare budget making in the future. However, little is known about the economic burden of lung cancer in China.

Methods: A prevalence-based approach was adopted to estimate the economic burden of lung cancer, including direct expenditure (medical and non-medical) and indirect cost (disability and premature death). Data on direct expenditure and work-loss days per patient in each year post-diagnosis were obtained from two primary surveys. Other parameters were obtained from literatures and official reports. Projections were conducted based on varying parameters. All expenditure data were reported in United States dollars (USD) using 2017 value (exchange rate: 1 USD= 6.760 CNY), with the discount rate of 3%.

Results: The total economic burden of lung cancer was estimated to be 25,069 million USD in China in 2017 (0.121% of gross domestic productivity, GDP). The estimated direct expenditure was 11,098 million USD, up to 1.43% of total healthcare expenditure for China, covering 10,303 million USD and 795 million USD for medical and non-medical expenditure, respectively. The estimated indirect cost was 13,971 million, including 1,517 million USD due to disability and 12,454 million USD due to premature death. Under current assumptions, the projected total economic burden would increase to 30.1 billion USD, 40.4 billion USD, and 53.4 billion USD in 2020, 2025, and 2030, accounting for 0.121%, 0.131%, and 0.146% of China's GDP, respectively. However, if China meets the United Nation sustainable development goal of reducing premature death from non-communicable diseases by one-third by 2030, the total economic burden in 2030 would be 31.9 billion USD, 0.087% of China's GDP.

Conclusions: The economic burden of lung cancer in China in 2017 is substantial and more likely to increase significantly in the future. Policy makers need to take urgent actions in budget making for health systems. The economic burden could be alleviated by reducing the disease burden of lung cancer via effective control and prevention actions.

Keywords: China; Lung cancer; cost of illness; population-level; prevalence.

1

Methodology estimating overall population-level economic burden of lung cancer in China. (A) Overall framework for economic burden of lung cancer; (B) Methods to estimate direct expenditure and indirect cost by disability of lung cancer; (C) Methods to estimate indirect cost by premature death of lung cancer.

2

Break-downs of population-level economic burden of lung cancer in China in 2017, by subgroup. (A) Overall; (B) by age; (C) by gender; (D) by region; (E) by cancer stage; (F) by smoking status; (G) by health insurance status; (H) by health insurance location. DM, direct medical expenditure; DNM, direct non-medical expenditure; IDIS, indirect cost by disability; IPD, indirect cost by premature death.

3

Projections for population-level economic burden of lung cancer in China. (A) total economic burden; (B) percentage to GDP of China. GDP, gross domestic productivity. GDP was from Organization for Economic Co-operation and Development.

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Break-downs of projected economic burden of lung cancer in China, in 2020 (A), 2025 (B) and 2030 (C).