Pricey treatments behind sharp rise in cancer care costs

The rising expenditure on cancer care is mainly caused by changes in the treatment landscape, according to a recent analysis by the RIVM and the Comprehensive Cancer Center of the Netherlands (IKNL). This concerns, for example, the introduction of new medicines and early detection. The increasing number of cancer patients due to population growth and aging plays a smaller role in the growth of expenditure, the researchers said.

The analysis examined the relationship between the number of new diagnoses and healthcare expenditure for seven types of cancer with the highest costs involved. Between 2003 and 2018, the number of diagnoses of these types increased from 47,000 to 68,000. In the same period, healthcare expenditure for cancer almost quadrupled, from 711 million euros to 3.7 billion euros. The increase is greatest among younger patients because they are often treated more intensively.

The new treatments have made “significant progress” in the survival rates for several cancer types. However, the researchers warn that further growth in expenditure could displace other care. “We need to have a debate about what really matters: how do we balance innovative treatments, rising costs, and the sustainability of the healthcare system,” said study author Chantal Pereira. “Are we investing enough in prevention? Because ultimately, we don’t want anyone to have this disease.”

“If healthcare expenditure per patient increases so much, we need to carefully consider what gains are in return. For example, in survival or quality of life,” added Mieke Reuser, project leader at the RIVM.” These difficult choices need to be made in the context of sustainable and affordable healthcare: every healthcare euro can only be spent once.”

Dutch health insurers recently caused unrest among patients with hormonal metastatic breast cancer when they stopped fully reimbursing two of the three medicines used to treat this disease. After price negotiations with the involved pharmaceuticals, only Pfizer agreed to lower the price. So the health insurers now only cover Palbociclib, and no longer Ribociclib and Abemaciclib.