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From the cancers included in the analysis for 2018, trachea, bronchus, and lung cancer had by far the highest total medical costs, followed by colon and rectum cancer, and breast cancer.
The high total medical costs, represented by the bubble size, for trachea, bronchus and lung cancer seem to be driven by a combination of high average attributable medical costs and a medium to high number of cases. For colon and rectum cancer and breast cancer, the high total medical costs seem to be connected to the cancers being relatively common.
It should be noted that costs vary depending on factors like how long someone has had the cancer and whether they have cancer in more than one part of their body. Cancers like bronchus and lung cancer, liver cancer, pancreas cancer, and mesothelioma tend to have high costs. This could be because these cancers often have poor survival rates and shorter durations, leading to higher initial treatment costs and higher end-of-life costs. In the analysis, costs tend to decrease the longer someone has had cancer, and they tend to increase if someone has cancer in more than one part of their body [1].
The results of the cost of cancer study were published in a scientific article
The data source for the cost of cancer analysis is the Belgian Cancer Registry linked with health insurance data from the Intermutualistic Agency. The Belgian Cancer Registry collects information on cancer diagnoses in Belgium. The Intermutualistic Agency (IMA) gathers information on direct healthcare costs, compiling the healthcare expenses from all public health insurances in Belgium.
The medical costs of cancer are calculated by comparing the total medical expenditure for people who have cancer, compared to people who do not have cancer. We looked at cancer cases from the past 10 years and focused on the costs for the year 2018. The people with cancer were matched with people who do not have cancer based on age, sex, region of residence, and preferential reimbursement status. The matching cancels out the effects that these factors have on health expenditure and helps us get a clearer picture of how much a particular cancer is impacting the costs.
Please cite this page as: Sciensano. Cost of illness: cancer, Health Status Report, 11 Apr 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/cost-of-illness/cancer
When we compare cirrhosis, acute cerebrovascular disease (stroke), and acute myocardial infarction (heart attack), stroke had the highest total hospital costs in 2020.
When we compare the total hospital costs with other estimates of disease burden, we see that the diseases appear in different parts of the graph. Hospital stays for cirrhosis of the liver are less common (left part of the graph), and the total costs are relatively low compared to cardiovascular diseases (small bubble). Strokes and heart attacks are more common than liver cirrhosis, and have high total hospital costs.
The total hospital costs for strokes seem to increase in recent years. The total hospital costs for heart attacks and cirrhosis seem to be stable over the years.
The best data source for each disease is determined by a critical appraisal [3]). The analysis of the costs of cardiovascular diseases and cirrhosis on this webpage is based on the hospital discharge data from the Technical Cell for data processing regarding hospitals [1, 2]. This dataset is based on linked and validated data from the Minimum Hospital Summary of the FPS Public Health and on INAMI billing data. The latter comes from the anonymous hospital stay (SHA-AZV) documents sent by the insurers [1].
We received the total hospital costs and number of hospital stays for all years by disease directly from the Technical Cell. To calculate the average costs per hospital stay for the bubble graph, we divided the total hospital costs by the number of hospital stays.
Please cite this page as: Sciensano. Cost of illness: hospital stays, Health Status Report, 22 Apr 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/cost-of-illness/hospital-stays
From the health conditions defined based on medication use included in the analysis for 2021, diabetes has by far the highest total medical costs, followed by Parkinson’s disease, and Alzheimer’s disease and other dementias. It should be noted that the costs for long-term care (e.g., nursing home care) is generally not part of the analysis, unless expenses are reimbursed by the compulsory health insurance.
The high costs of diabetes, compared to Parkinson’s disease and dementia, is mainly driven by the high prevalence of the disease. Parkinson’s disease and dementia are more costly to treat, but are also less prevalent than diabetes, so the total costs are relatively low compared to diabetes.
There has been an increase in the total costs for all three diseases in recent years, with the strongest increase in the costs of diabetes.
The costs of the different diseases are estimated based on different data sources. The best data source for each of the diseases is determined by a critical appraisal [2]).The data source for this analysis is the Permanent Sample of the Intermutualistic Agency. The 'permanent sample' is a database on health care utilisation. These data do not cover the total population, but only a representative selection. The sample includes data on consultations and visits to doctors, prescribed drugs, hospital admissions, nursing services, etc., [1, 3]
We estimate the incremental or additional costs attributable to each of the health conditions based on medication use. We adjust the costs based on factors like age, gender, reimbursement status (which gives us an idea of income or disability), and the region where a person lives. These factors can affect the chances of getting sick or having higher healthcare costs. Therefore, when we make these adjustments, we are essentially taking out the influence of things like age or gender. This helps us get a clearer picture of how much a particular disease alone is impacting the costs.
Please cite this page as: Sciensano. Cost of illness: health conditions based on medication use, Health Status Report, 22 Apr 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/cost-of-illness/health-conditions-based-on-medication-use
From all the self-reported health conditions included in the analysis for 2018 back pain had by far the highest total medical costs, followed by chronic obstructive pulmonary disease and angina pectoris (chest pain or discomfort that can be a symptom of coronary heart disease).
Back pain and neck pain are quite common (right side of the graph), and they are connected to moderately high medical expenses per person. These conditions therefore contribute substantially to healthcare costs, as indicated by their large bubble. Cardiovascular diseases are less common (left side of the graph), but they are associated with high medical costs per person (upper side of the graph). The high total medical costs of chronic obstructive pulmonary disease and depression seems to be the result of moderate to high costs and a moderate number of cases.
Back pain ranked the highest in terms of the total attributable costs in both 2013 and 2018. There seems to be a downward trend in total medical costs for all diseases except eye disorders, particularly glaucoma (a group of eye diseases that can cause vision loss and blindness). It should be noted that the number of people with eye disorders in the HISlink samples are relatively low. This means that it can be difficult to estimate costs and that there is a lot of uncertainty around these estimates.
The data source for this analysis is the Health Interview Survey Data linked with Health Insurance Data (HISLink [1, 2]). In the Health Interview Survey, people are asked about possible health conditions that they may have. The Intermutualistic Agency (IMA) gathers information on direct healthcare costs, compiling the healthcare expenses from all public health insurances in Belgium. The HISlink data source therefore contains information both about people’s healthcare expenses, and their health conditions.
We estimate the incremental or additional costs attributable to each of the self-reported health conditions. We adjust the costs based on factors like age, gender, reimbursement status (which gives us an idea of income or disability), and the region where a person lives. These factors can affect the chances of getting sick or having higher healthcare costs. Therefore, when we make these adjustments, we are essentially taking out the influence of things like age or gender. This helps us get a clearer picture of how much a particular disease alone is impacting the costs.
Please cite this page as: Sciensano. Cost of illness: self-reported non-communicable health conditions, Health Status Report, 22 Apr 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/cost-of-illness/self-reported-non-communicable-health-conditions