The cost of metastatic prostate cancer using time-driven activity-based costing.

OBJECTIVE: To estimate the cost of metastatic prostate cancer (mPC) treatment using the time-driven activity-based costing (TDABC) method from the perspective of a philanthropic hospital in the Brazilian public health system (PHS) and to identify determinants of costs. METHODS: We used data from patients who received docetaxel chemotherapy in the Brazilian PHS from September 2012 to May 2017. Direct medical costs were estimated with the TDABC microcosting method, taking into account the multiple departments and services the patients interacted with during their oncological treatment. RESULTS: The median overall survival of the forty-three patient sample was 1.8 years (95% CI 1.45-2.30), and the total cost of the sample was BRL 917.005 (USD 250,878). The median monthly cost per patient was BRL 20.201 (USD 5,526). The end-of-life cost per patient using the TDABC method was BRL 5.151 (USD 1,409). Patients who had received previous treatment at the center registered the lowest cost for hospitalizations and exams, suggesting an opportunity to better manage healthcare resources. CONCLUSIONS: This is the first study on the economic burden of mPC in the Brazilian PHS using the TDABC costing evaluation method. Accurate cost information obtained with the TDABC can be helpful in guiding disease management to guarantee better use of ever-scarcer resources.

The epidemiology of cancer in Angola-results from the cancer registry of the national oncology centre of Luanda, Angola.

Knowledge of the epidemiological profile of cancer is a key step in planning national cancer policy. The main objective of this study was to characterize the epidemiological profile of cancer in Angola based on cases of cancer registered at the National Oncology Centre (NOC) of Luanda, the only Angolan hospital to specialize in cancer treatment and diagnosis. The study consisted of a cross-sectional historical review of cases treated at the NOC between 2007 and 2011. The following variables were analysed: tumour location, diagnostic basis, and source of referral, as well as patient age, sex, place of residence, and the stage of the disease. The NOC registered a total of 4,791 patients throughout the study period, at an annual average of 958 cases. The most commonly diagnosed cancers were breast (20.5%), cervical (16.5%), and head and neck cancer (10.6%), followed by lymphoma (7.2%), Kaposi sarcoma (6.1%), and prostate cancer (4%). A total of 76% of patients were under 60 years old, and 10% were less than 15 years old. Of the total number of patients with cancer treated at the NOC, 77.3% lived in the Luanda province. Staging data were only available for patients with breast or cervical cancer, and an analysis of this variable showed that most of these individuals were in advanced stages of the disease. In the absence of a population-based cancer registry, this study constitutes a reasonable assessment of the epidemiological profile of cancer in Angola.