LAUSR

The aim of this study is to assess the economic burden of active cancer in France and to analyze structure and trends of expenditure between 2012 and 2017. Using information about 57 millions of individuals from the general scheme insurance database (86% of the French population) and applying 5 specifically developed medical algorithms (for lung, colon, breast, prostate and other cancers), we identified all people with active cancer. All reimbursed expenditure (hospitalization, ambulatory care, disability/sickness benefits) were extracted for each individual. To analyze trends, we applied the same methodology from 2012 through 2017. In 2016 (results for 2017 will be available for the conference), among the 137 billion euros reimbursed by the general assurance scheme, 13 billion (10%) were related to active cancer and 1.2 million people were concerned (2% of the population). About 2.3 billion euros (2%) were related to breast cancer (189,000 people), 1.4 billion euros (1%) for colon cancer (123,000 people), 1.4 billion euros (1%) for lung cancer (77,000 people) and 1 billion (0.8%) for prostate cancer (167,000 people). Hospitalizations represented the main expenditure for colon (71%), lung (61%) and breast cancer (56%). Concerning prostate cancer, hospitalizations stood for 36% while ambulatory care represented 62%. From 2012 to 2016, the expenditure related to active cancer increase by 4.4%/year due to both an increase in patients and in the average annual cost per patient (both +2.2% per year). Focusing on breast cancer, average expenditure increased by 3.2% per year from 10,700€ per year per patient to 12,200€ per year per patient. Our study demonstrates the high economic burden of active cancer in France with a detailed analysis of expenditures. The developed tool will help to monitor the burden of these diseases and to implement public health policies. Active cancers account for a significant proportion of healthcare expenditure in France. Knowing this weight allows designing and implementing public policies adapted to the situation.