The national health system is unable to cover all needs, so the burden falls on patients and family members, who pay above all for diagnostic tests, transport and specialist visits. The results of a survey promoted by Favo, Aimac and the Cancer Institutes of Milan and Naples
Getting cancer can be very expensive, not only for the physical and psychological cost, but also in cash. On average, every Italian cancer patient pays out 1,841 euros each year from your bank account, both to receive health services that should be paid for by the regional health services, and for travel from one’s 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 certainly more and more 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 a tumor are an increasingly present phenomenon also in our country – he 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, one of the leading Italian experts on the subject -. Especially in the United States, where there is no universal healthcare system like ours but everything passes through the 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 (also due to the impact that the disease has on work and the expenses of the entire 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. Not a few patients even decide to give up the treatments cancer patients, 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 -. I am more and more people who fall ill with cancer and also end up having economic difficulties, due to “narrower” medical expenses, transport to reach the hospital and accommodation, up to the need for cleaners and caregivers. And to be eroded not only the Bank account of the person concerned, because the problems affect the entire family nucleus, also involving those who assist him: spouses, children, brothers and sisters, first of all. As confirmed by this last Italian study, the item that seems to have the most impact on the expenses incurred directly by patients is that relating toi diagnostic tests (reported by 51.4% of the interviewees, for an average of almost 260 euros per year). Following: the cost of the means of transport (45.1%, almost 260 euros), le specialistic examinations following the diagnosis (28.9%, 126 euros), the purchase of drugs non-oncological (28.5%, 124 euros) and expenses foraccommodation far 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
From the Italian statistics it emerged that about a quarter of the patients complained of financial hardship related to the disease and its treatment – emphasizes 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 they find themselves forced to resort to the private sector to overcome them, by paying visits and exams that the NHS is not currently able to ensure in a timely manner to all those who need it. 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 SSN represents a great heritage, which allows citizens to continue to have access to treatment more and better than in many other countries – says Perrone -. It is a heritage which 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 carried out by Datamining, in collaboration with the Italian Association of Cancer Patients, relatives and friends – Aimac, the National Cancer Institute of Milan and the Pascale one in 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 centres. According to the study’s conclusions, private spending among cancer patients is especially common among patients living in the regions of the Center and North of the country. E 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 Analytical Epidemiology and Health Impact Service 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 – he concludes Francesca Tracl, contact person of the firm and member of the Aimac board of directors – confirm that some needs of cancer patients remain unmet. 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.
April 14, 2023 (change April 14, 2023 | 5:43 pm)
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