Financial Aspects of the Tumor Immunology

TitleFinancial Aspects of the Tumor Immunology
Publication TypeBook Chapter
Year of Publication2016
Book TitleTumor Immunology
SectionFinancial Aspects of Tumor Immunology
Pagination339-363
Publication Languageeng
AuthorsRidic, O, Ridic, G, Slipicevic, O, Jukic, T
PublisherMAX MEDIA d.o.o. Sarajevo
Place PublishedSarajevo
ISSN Number978-9926-8092-0-1
Other NumbersCOBISS.BH-ID 23064838
Abstract

The largest contribution of tumor immunology is in the prevention of malignant tumors, as one of the most complex, the most dangerous and the most expensive diseases to treat in the past, present and future. Tumor Immunology is a constantly developing field of medical science, which has enormous potential. It is supposed to teach/direct an extremely complex human immune system as to how to detect the cancer cells and understand how cancer cells avoid control / defense mechanisms of the human immune system. Malignant neoplasms annually cause the deaths of more than 7.5 million people, globally. The number of patients, primarily, due to the aging of the human population, is expected to grow. Likewise, treatment protocols will be more complex, and at the same time more expensive. The challenges that are set for, both, developed and developing countries, are primarily to deliver adequate health care and make it affordable to all patients. According to the Dayton Peace Agreement signed in 1995, Bosnia and Herzegovina (B&H), consists of two entities: Federation of Bosnia and Herzegovina (F.B&H), Republic Srpska (RS) and Brčko District. Data on the total number of patients, the cost of certain methods of treatment (e.g., radiotherapy, cytostatics, biological anti-cancer drugs, etc.) and total cost of treatment of malignant diseases are presented for F.B&H and RS, while data for the Brčko District, were not available. In order to research the problem, a thorough literature review of secondary sources of information (i.e. government/Statistics agencies' publications/reports, peer-reviewed journal articles, electronic internet sources, etc.) was conducted in order to investigate a documented prior research results. The research of secondary sources was conducted in a cross-sectional time frame manner, in the period, November, 2014 – November, 2015. In F.B&H, the total cost of treatment of malignant diseases was the highest in 2011 and amounted to 60,260,062.00 B&H convertible marks (BAM) to show a tendency to decrease, and in 2014 amounted to 56,788,518.00 BAM. Consumption of the cytostatics in F.B&H, for the period 2003-2013, was continually growing. The only exception was the year 2011, where the consumption of cytostatics was lower than in the previous two years (2010 and 2009). In contrast to data for Federation entity, in the RS entity, the cost of treatment and number of patients recorded a constant growth, according to data that were available for the period from 2003 to 2013. For example, the number of patients in RS entity who in 2003 utilized anti-cancer drugs and radiation therapy services totaled 3,938. Five years later, in 2008, that number rose to 7,123, and in 2013 was 9,689 patients. For the future research, it would be important to analyze the factors affecting the increase in the cost of treatment of malignant neoplasms in F.B&H, as well as the factors influencing the reduction in the total cost of the almost constant number of patients in the RS, for the period 2011-2014. As far as the world is concerned, a continuous research is needed to discern as to how the financial stimulations can potentially lead to a costly overuse of medications, technologies and procedures. Health care, in general, and care of patients with malignant neoplasms, specifically, are very expensive. Costs are growing at a rate that exceeds the rate of inflation and consumes a larger part of the limited funds that are intended for the national budgets of the individual, in almost all countries. Many new treatments of malignant neoplasms and technologies are available, and the results show improvements in many areas, but increasingly we are faced with the question of whether the sometimes minor improvements in life expectation, are worth the cost they pose to the individuals and society. New, more effective and less toxic interventions are necessary, but the cost of these innovations more and more increases the costs of care. The economic impact of health care for patients suffering from malignant neoplasms can be measured as: the total (aggregate) cost, the percentage of national gross domestic product (GDP) or as a cost of treatment of the individual patient (eng. per capita spending). Directing adequate resources to the prevention and treatment of malignant neoplasms, as well as the research that would aim to eliminate malignant neoplasms in all forms, is the challenge and one of the most important tasks in the future. Right now, we are at a crossroads, where our choices, or refusal to make choices, have clear implications for our ability to provide more effective and efficient cancer care for the increasing number of patients in B&H and the world.