Cost of Illness

The economic impact of diseases on society

This chapter presents the results of the cost of illness estimates for the Belgian National Burden of Disease Study (BeBOD). The BeBOD study quantifies the health impact of 38 key diseases in terms of Disability-Adjusted Life Years (healthy life years lost due to morbidity and mortality).

The cost of illness study complements the health impact estimates by providing a description of the economic impact of diseases on our society. Looking at different types of information (health impact, economic impact) helps governments and service providers have better evidence to figure out what is most important and shape plans and policies that can meet the needs of the people affected.

To calculate the economic impact of diseases in Belgium, we estimated the costs of hospitalizations and outpatient visits, including medication (direct medical costs). We analyzed self-reported non-communicable health conditions, health conditions defined based on medication use, cancer, and hospital stays.

1. Self-reported non-communicable health conditions
   Musculoskeletal disorders had the highest economic burden in 2018 of all self-reported health conditions included in the analysis. Musculoskeletal disorders are common, and associated with moderately high medical expenses. The total medical costs of self-reported health conditions were lower in 2018 compared to 2013, except for eye diseases.
2. Health conditions based on medication use
   The economic burden of diabetes is high, due to the disease being very common. The costs of diabetes have increased since 2014.
3. Cancer
   Lung cancer is the most costly cancer, followed by colon and rectum cancer, and breast cancer. Lung cancer is both common and costly to treat. Many of the high cost cancers can be prevented by tackling risk factors such as smoking, obesity, and environmental stressors.
4. Hospital stays
   Hospital costs are highest for stroke. The average costs per hospital stay for cardiovascular diseases (strokes, heart attacks) are high. Hospital costs for stroke seem to have increased in recent years.

What does it mean when a disease is linked to high direct medical costs?

It is important to understand that diseases and their effects on people, society, and the health system are complicated. A disease might have a big impact on people but not cost a lot in terms of health spending, or the other way around. When a disease has a high human cost but low spending, it does not automatically mean that more money should be spent on healthcare. Some treatments are more expensive, and for issues like road transport injuries or smoking-related diseases, the solutions may involve investments and actions outside the health system, like in education, transportation, environmental health, or other social services [1].

Different diseases, different data sources

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]. Currently, the estimates are based on four different data sources: 

1. Self-reported non-communicable health conditions
   Health Interview Survey linked to data from the Intermutualistic Agency [3,4]
2. Health conditions based on medication use
   Permanent Sample of the Intermutualistic Agency [5]
3. Cancer
   Belgian Cancer Registry linked to data from the Intermutualistic Agency [6]
4. Hospital stays
   Hospital discharge data from the Technical Cell for data processing regarding hospitals [7,8]

Since it is difficult to compare costs from different data sources, we present the costs of the different diseases by data source.