expenses of Italian patients amounting to over 1,800 euros a year, especially at Nord-breaking latest news

Getting cancer can be very expensive, not only for the physical and psychological cost, but also in cash. On average, every Italian cancer patient disburses 1,841 euros each year from their bank account, both to receive health services that should be paid for by the regional health services, and for travel from their city of residence. This is what emerges from the data collected for a survey published in The European Journal of Health Economics, promoted by the Italian Federation of Volunteer Associations in Oncology (Favo), and presented this morning at the Chamber of Deputies in Rome. Experts call it financial toxicity: the problem, unfortunately, is not new, but it is certainly increasingly serious. So much so that the number of studies documenting it is growing and that it is being talked about more and more often.

The bankruptcy alarm coming from the United States

Economic hardship and inequalities in access to care were, in fact, the central theme of both World Cancer Day 2022 and the last annual congress of the American Society of Clinical Oncology (ASCO). The economic difficulties caused by cancer are an increasingly present phenomenon in our country as well – explains Francesco Perrone, president-elect of the Italian Association of Medical Oncology (Aiom) and director of the Clinical Trials Unit of the Pascale National Cancer Institute of Naples, among the leading Italian experts on the subject -. Especially in the United States, where there is no universal health system like ours but everything passes through health insurance (inaccessible to millions of less well-off Americans), inequalities are growing between those who can afford to pay for the best therapies and those who cannot (even due to the impact that the disease has on the work and expenses of the whole family). And there’s more: young adults use crowdfunding, a form of collective financing, to raise the money needed to heal themselves, then suffering from shame and embarrassment. Quite a few patients even decide to give up cancer treatments, thus preventing the disease from leading them to bankruptcy and ruining the life prospects of the whole family. If the problem is already widespread in America, should we expect, as often happens on other fronts, that the US will anticipate what will happen sooner or later here too?

Where 1,800 euros are spent

Thanks to the health system in Italy, the costs of therapies are “covered”, but even here, those who fall ill often have to face a series of even very significant extra expenses, to which is added a decrease in revenue due to the drop in productivity and the repercussions at work – replies Perrone -. More and more people fall ill with cancer and also end up having economic difficulties, due to “stricter” medical expenses, transport to reach the hospital and accommodation, up to the need for cleaners and carers. And it is not only the bank account of the person concerned that has been eroded, because the problems affect the entire family nucleus, also involving those who assist him: spouses, children, brothers and sisters, first and foremost. As confirmed by thislast Italian studythe item that seems to have the most impact on the expenses incurred directly by patients is that relating to glthe diagnostic tests (reported by 51.4% of the interviewees, for an average of almost 260 euros per year). Followed by: the cost of means of transport (45.1%, almost 260 euros), specialist visits following the diagnosis (28.9%, 126 euros), the purchase of non-oncological drugs (28.5%, 124 euros) and expenses for accommodation away from one’s residence (26.7%, 226 euros). Without forgetting nutritional advice, prostheses and wigs, home care, psychological support and rehabilitation, which remains a luxury for a few, but a necessity for almost all patients.

The difficulties of the NHS

Italian statistics have shown that about a quarter of patients complained of economic hardship linked to the disease and its treatment – underlines Francesco De Lorenzo, president of Favo and Aimac -. Once again the work of the world of oncological volunteering, with its own structures and means, but thanks to the traditional alliance with the Institutes of Hospitalization and Treatment of a Scientific Character, has highlighted with this research problems that weigh on the life of oncological patients. Patients are aware that long waits have a heavy impact on diagnostic delays and find themselves forced to resort to private services to overcome them, paying for visits and tests that the NHS is not currently able to promptly ensure to all those who need them. The situation has worsened over the years and it is hoped 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. 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 – says Perrone -. 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 better treating cancer patients.

Who spends more

The survey just presented in Rome in its second edition (the first dated 2012, again promoted by Favo and created by Datamining, in collaboration with the Italian Cancer Patients Association, relatives and friends – Aimac, the National Cancer Institute of Milan and the Pascale Institute of Naples) and involved almost 1,300 patients in therapeutic treatment 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 pursue the most suitable therapeutic path for their disease – says Alessandro Sproviero, CEO of Datamining -. The survey took place in 39 Aimac reception and information points present in the major national centers. According to the conclusions of the study, private spending among cancer patients is widespread above all among patients living in the central and northern regions of the country. AND to draw more on their savings are above all those who face the recurrence of a disease diagnosed years earlier: in the early stages, patients are able to benefit more from the offer of the NHS. Italian cancer patients have incurred significant private costs to integrate NHS services in diagnosis, treatment support and rehabilitation: all important aspects for the final outcome, recovery and quality of life – highlights Roberto Lillini, researcher of the Epidemiology Service analysis and health impact of the National Cancer Institute of Milan, among the authors of the study -. The costs incurred for diagnosis through private structures were particularly burdensome, but not deferrable, when the public alternative implied waiting too long for the disease to be diagnosed or investigated. The results of our survey – concludes Francesca Tracl, contact person for the study and member of the Aimac board of directors – 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.