The economics of cancer care in the UK

Cancer care accounts for an increasing proportion of global spending on healthcare, driven by an increased incidence caused by ageing populations, greater frequency from better treatments, and changes in care that have made cancer a chronic, controllable illness. The cost of cancer care has three components: direct and easily determined clinical costs (ie, medical costs); extra financial requirement of living with disease for the patient and their family (ie, morbidity costs); and loss of income from the premature death (ie, mortality costs). Effective planning of cancer services needs detailed consideration of the economics of care delivery-an area of research that has so far been lacking outside the USA. Here, we review the literature and attempt to answer key questions on the economics of cancer care, including probable changes in disease burden over the next 20 years, changes in the way costs will be distributed between carers and delivery services, changing patterns of service delivery, and the direct contribution patients will make to treatment costs in terms of co-payments and escalating costs of comorbidity in elderly populations.