An average expense of nearly 2,000 euros a year. To carry out diagnostic tests and specialist visits, undergo life-saving therapies and receive treatments such as psychotherapy and nutritional support that contribute to increasing survival rates and the quality of life of cancer patients. In many cases hundreds of kilometers from home, an aspect that contributes to increasing the economic burden on the pockets of patients and their families.
These are the data presented by FAVO, the Italian federation of voluntary oncology associations, to the Chamber of Deputies, results of a survey promoted by Favo, Aimac and the National Cancer Institutes of Milan and Naples and which involved almost 1300 patients.
The study demonstrates how the National Health Service is currently unable to ensure timely access to diagnostic tests, cancer treatment and social support for all patients that they need it. And the situation is made worse by the long waiting lists.
In fact, people find themselves (more than before) having to resort to paying for these services out of their own pockets, giving priority above all to those related to early diagnosis and some treatments. And neglecting, due to economic difficulties, those more linked to the quality of life.
EVERY CANCER PATIENT SPENDS 1,841 EUROS EACH YEAR ON TREATMENT
The second edition of the survey “The social costs of cancer: evaluation of the social and economic impact on patients and caregivers” reveals a reality unfortunately known to Italian families who live with a person with cancer.
I51.4% of the interviewees indicated diagnostic tests whose cost is 260 euros per yearfollow i transport in 45% of cases with an annual expense of 359. 29% of the answers concerned the post-diagnosis specialist visits with an expense of 126 euros per year, i oncological drugs are burdensome for 28.5% of people with a cost of 124 euros per year
From the results of the survey, published in “The European Journal of Health Economics”, a series of significant and widespread critical issues, albeit unevenly throughout the country. «The sample survey involved almost 1,300 therapeutic treatment patients who had received a diagnosis between 2011 and 2018, with the aim of investigating the extent to which patients had drawn on their savings to carry out the most suitable therapeutic path for their disease – reports Alessandro Sproviero, CEO of Datamining -. Detection has taken place in 39 Aimac reception and information points present in the major cancer diagnosis and treatment centers distributed equally throughout the country and the sample of the population being treated took into account the gender and tumor site”.
From the answers provided by the patients to the 38 questions posed to quantify the expenses (medical and otherwise) incurred directly to fill shortcomings and delays in the national health service, it emerged that on average every Italian cancer patient spends 1,841 euros every year to receive healthcare services which should be paid by regional health services. “Once again the work of the world of oncological volunteering, with its own structures and means, but with the traditional alliance with the Institutes of Hospitalization and Treatment of a Scientific Character, has rigorously highlighted the problems that weigh on the life of oncological patients – he explains Francesco De Lorenzo, president of FAVO and Aimac –. I patients are aware that long waits have a heavy impact on diagnostic delays and find themselves forced to resort to the private sector to overcome them. The hope is that these data will convince political decision-makers to intervene immediately, to prevent the weakest sections of the population from paying the price for these dysfunctions».
Message shared by Luciano Ciocchetti, Vice-President of the Social Affairs Commission of the Chamber: «The question of the private costs incurred by cancer patients and their families and caregivers is an issue that absolutely needs to be addressed. It is necessary to improve the care of patients from the first moment, including all the required control tests in the process and providing all the necessary supports to preserve their quality of life. My proposal for a law for the establishment of the figure of the basic psychologist also derives from this will. This research will help the Government, the legislator and the regions to deal with these issues in a more in-depth manner”.
The Honorable Ciani adds: «As a welfare model, Italy has always focused on safeguarding the health of its citizens, with particular attention to the most fragile people such as those who find themselves in a situation of serious illness such as oncology . The study on the social and health costs incurred by cancer patients is a precious testimony of the Italian reality, which certainly highlights the importance of a health system that tries to guarantee the right to health for all citizens, regardless of their socio-medical conditions. cheap. However, the results of the report also remind us of the urgency of addressing some critical issues still present in our health system, such as the shortage of medical personnel, the need to strengthen support for the families of cancer patients, ensure timely access to diagnostic tests and cancer treatment and last but not least invest in local medicine to ensure, where possible, treatment at domicile. At a time when public health has been challenged by the COVID-19 pandemic, this study offers us food for thought on how to make our health system more effective and sustainable.”
THE MOST RELEVANT SHARE OF EXPENDITURE FOR DIAGNOSTIC TESTS AND TRAVEL
The item that seems to have the greatest impact on the expenses incurred directly by patients is the relative one to diagnostic tests (reported by 51.4 percent of them). Followed by: the cost of means of transport(45.1 percent), the post-diagnosis specialist visits (45.1 percent), the purchase of non-oncological drugs (28.5 percent) and expenses for the accommodation far from one’s residence (26.7 per cent).
The survey also highlighted that an impact on diagnostic expenditure (on average: 259 euros per year) could also be inappropriately prescribed tests. And which, not being deemed necessary in an evaluation that crosses costs and benefits, are left to be paid by the patients. Lastly, among the other most frequently recorded expenditure items, there is the provision of treatments psychological support, consultations with the nutritionist, the purchase of prostheses, wigs and wheelchairs and home visits by doctors and nurses.
“The national health service represents a great asset, which allows citizens to continue to have access to treatment more and better than in many other countries – he argues Francesco Perrone, director of the clinical trials and Phase 1 studies unit at the National Cancer Institute Pascale Foundation in Naples and president-elect of the Italian Association of Medical Oncology (Aiom) –. It is a heritage that needs to be defended, but also strengthened where inefficiencies and deficiencies are identified. Its correct functioning is directly connected to the possibility of treating cancer patients in the best possible way. Those who face the disease in a condition of economic difficulty see their lives conditioned by the disease both in terms of quality, but also, dramatically, in terms of survival prospects”.
TO SPEND MORE PATIENTS IN CENTRAL AND NORTHERN ITALY
According to the conclusions of the study, private spending among cancer patients is especially widespread among patients living in the central and northern regions of the country. “In 2018, Italian cancer patients incurred significant private costs to integrate the services of the National Health Service in the areas of diagnosis, treatment support and rehabilitation that are important for the final outcome, recovery and quality of life – he saysRoberto Lillini, researcher of the analytical epidemiology and health impact service of the National Cancer Institute of Milan, one of the authors of the study -. In particular, i costs incurred for diagnosis through private structures were particularly burdensome, but not deferrable, when the alternative in public facilities implied waiting too long for the disease to be diagnosed or investigated. However, this choice has often led to having to give up other services not sufficiently provided by the National Health Service, but still important for a good outcome of the treatment and the patient’s quality of life. Particularly in problematic socio-economic situations. The The NHS should therefore enhance its capacity to respond to the unmet needs of patients and survivors through public health actions which, by reducing socio-economic differences, would improve treatment throughout the course of the disease, from diagnosis to rehabilitation”. Adds Francesca Traclò, referent of the study and member of the board of directors of Aimac: «The results of our survey confirm that some needs of cancer patients remain unsatisfied. This situation increases the inequalities between patients characterized by different socioeconomic statuses. An unacceptable disparity, in the presence of a public health system which by its nature should guarantee equal access to health services for all citizens”.
THE LESS PROTECTED ARE THE MOST FRAGILE PATIENTS
Among the wide range of cancer patients, those who draw more on their savings are above all those who they face the recurrence of a disease diagnosed years earlier. In the early stages of treatment, cancer patients are able to benefit more from the offer of the national health service. This happens less frequently, however, in the later stages of the disease.
“The most vulnerable patients are also those who most often dig into their wallets to get treatment – concludes De Lorenzo – It is necessary to strengthen local medicine, also in the oncological field. The most advanced treatments should be carried out in reference centres. But once the acute phase of the disease has passed, the rest must be done mainly on the territory. Patients with an advanced disease, even when they do not recover, have the right to a dignified life in line with current therapeutic opportunities and to the best possible quality of life”.