LAUSR

Introduction: The purpose of the study is to estimate both the number of beneficiaries and the burden of the Disability Insurance (DI) benefits provided for neoplastic diseases (ND) and for five cancer types, focusing on the expenditure by the social security system. Methods: To estimate the current DI benefits and their cost, we analyzed the databases of DI awards and the mean cost per benefit of the Italian National Social Security Institute (INPS) for two types of social security benefits: the disability benefits (DB) for people with reduced work ability and the incapacity pensions (IP) for people without work ability. A probabilistic model with a Monte Carlo simulation was developed in order to estimate the total benefits provided and costs. Results: Between 2009 and 2015, a yearly average was estimated of about 122,000 beneficiaries of DI for cancer. The total estimated expenditure for ND in the seven years, supported and provided by INPS for these social security benefits, amounted to EUR 8.1 billion (corresponding to 27.4 percent of the total expenditure for disability provided by INPS) of which 66.7 percent was associated with DB and the remaining 33.3 percent with IP. The percentage increase related to the costs show that DB have the most significant increase starting from the 2013 with 11.3 percent from 2013 to 2014 and 9.7 percent from 2014 to 2015, while. IP have an increase from 2009 to 2011, with a maximum during 2011, with a percentage difference of 7.6 percent. Conclusions: The incidence and the prevalence of the ND are expected to increase in the coming years in Italy. In order to minimize the consequences of this scenario, rapid access to innovative treatments would reduce the costs borne by the social security system, accompanied by an improvement in the effectiveness of interventions and increase in quality of life for patients.