1.Provider Costs of Treating Colorectal Cancer in Government Hospital of Malaysia
Meram Azzani ; Maznah Dahlui ; Wan Zamaniah Wan Ishak ; April Camilla Roslani ; Tin Tin Su
Malaysian Journal of Medical Sciences 2019;26(1):73-86
Background: The incidence of colorectal cancer (CRC) is rapidly rising in several Asian
countries, including Malaysia, but there is little data on health care provider costs in this region.
The aim of this study was to estimate the cost of CRC management from the perspective of the
health care provider, based on standard operating procedures.
Methods: A combination of top-down approach and activity-based costing was applied.
The standard operating procedure (SOP) for CRC was developed for each stage according to
national data and guidelines at the University of Malaya Medical Centre (UMMC). The unit cost
was calculated and incorporated into the treatment pathway in order to obtain the total cost of
managing a single CRC patient according to the stage of illness. The cost data were represented by
means and standard deviation and the results were demonstrated by tabulation. All cost data are
presented in Malaysian Ringgit (RM). The cost difference between early stage (Stage I) and late
stage (Stage II–IV) was analysed using independent t-test.
Results: The cost per patient increased with stage of CRC, from RM13,672 (USD4,410.30)
for stage I, to RM27,972 (USD9,023.20) for Stage IV. The early stage had statistically significant
lower cost compared to late stage t(2) = −4.729, P = 0.042. The highest fraction of the cost was
related to surgery for Stage I, but was superseded by oncology day care treatment for Stages II–IV.
CRC is a costly illness. From a provider perspective, the highest cost was found in Stages III and IV.
The early stages conserved more resources than did the advanced stages of cancer.
Conclusion: Early diagnosis and management of CRC, therefore, not only affects oncologic
prognosis, but has implications for health care costs. This adds further justification to develop and
implement CRC screening programmes in Malaysia.