[The cost of chemotherapy]

Health expenditures keep increasing regularly for many years and the medical cost of cancer as well. French Social Security estimated in 1994 that reimbursed health care expenditures for cancer reached 5.3 billions euros (8% of health care budget). Two French studies based on 1996 and 1999 diagnosis related groups data suggest that 15 % to 25 % of stays in public hospitals are related to cancer. In these studies, the budget of public health system for cancer was estimated to 6 billions euros, among which chemotherapy accounted for 16% to 18%. French Health authorities data show that pharmaceutical sales for anticancer drugs, which are mainly delivered in the hospital sector (70%) are around 1.5 billion euros in 2002. The price of the new drugs explains a part of the burden of cancer in France as in the other countries. However other factors need to be highlighted especially the increasing incidence of cancer, the ageing of population and the enlarged number of eligible patients for chemotherapy. Finally, one should note that current French reimbursement system for chemotherapy modifies the management of patients (day care versus inpatient care) and the repartition of care between the public and private sectors.