The EPICOST project
Economic impact of cancer-related costs on Italian regional healthcare system: estimation of cancer burden and its economic impact according to different healthcare interventions.
The EPICOST project
Based on the described pilot study, the EPICOST project aims to build up a tool for evaluating the burden of colon, rectum, and female breast cancers, in Italy, and associated health care costs considering the number of cancer patients still alive in a certain period (prevalent cases) during specific phases of care. These are common tumours which account for a great number of prevalent cases depending the distance since diagnosis, due to a good prognosis, continuous improvements in diagnostic procedure and treatments, and finally the aging of population. In the near future, these tumours represent a new challenge to face for the Italian National Health Service: to provide an healthcare model which is both financially sustainable and efficient to an increasing number of patients.
The two-year project Epicost -started in march 2015- is funded by the National Centre for Disease Prevention and Control (CCM) which is a new public health entity of the Italian Ministry of Health aimed to optimise the plans and priority actions in terms of public health nationwide.
Epicost is organized into three units: the coordinator National center for disease prevention and health promotion (CNaPPS), Istituto Superiore di Sanità, the Institute for Research on Population and Social Policies (IRPPS) - National Research Council (CNR), and the Italian Cancer Registry Association (AIRTUM).
Project aim
To develop methodology and software tool for evaluating impact of colon, rectum, and female breast cancers on Italian Health Care System, with the objective of enabling health care planners to better understand cancer patients needs and to allocate financial resources to oncology.
Specific aims
To provide the distribution of health care expenditures according to the disease pathway -initial (one year following diagnosis), continuing (betweeninitial and final) and final (one year before death)- for subgroups of cancer survivors homogeneous with respect to their health care needs, on the basis of the reconstruction of pattern of care (POC) at individual level.
To calculate the number of prevalent patients who can be considered treatment-free for the three different cancer site (colon, rectum, breast in females) by age, sex and residence.
Materials and methods
Eight Italian CRs - coordinated by AIRTUM - participate to the project providing prevalence cohorts linked with administrative databases (hospital discharges, outpatient/ambulatory services, pharmaceutical files) at individual level, in order to reconstruct cancer POC and corresponding expenditures (cost profiles), in each phase of the disease. Prevalence date depends on the lenght of registration activity: 01/01/2009 for Tuscany CR, 01/01/2010 for Friuli Venezia Giulia/Veneto CR, 01/01/2011 for the others CRs.
Data linkage is the preliminary step in order to reconstruct the POC of prevalent patients, at individual level, along the entire disease pathway. The POC will be then used to calculate the cancer specific average cost profiles of prevalent patients by Italian regions, stratified according to the main determinants of the health care pathway: site, age group and tumor stage at diagnosis.
Written by Sandra Mallone CNaPPS - Istituto Superiore di Sanità