The economic burden of cancer in Canada

February 8, 2021

Learn more about the direct out-of-pocket costs, indirect costs and psychosocial costs of cancer

Cancer has an impact not only on a person’s health, but also on their personal finances, employment status (employed, full or part-time, versus unemployed) and quality of life. It’s important to understand these costs, and who bears them. What’s more, this information can help inform patient supports needed, help aid in the allocation of scarce resources and, ultimately, help support decision‐making in cancer care system.

In support of the Canadian Strategy for Cancer Control, the Partnership is embarking on work to better understand the economic burden of cancer faced by patients and their families. Priority 3 calls for a sustainable system, Priority 4 calls for the elimination of barriers to care, and Priority 5 calls for the delivery of information and supports for people living with cancer and for their families and caregivers.

As the first step in this work, the Partnership scanned the international and national literature to better understand how studies have defined and measured the economic burden of cancer. The findings from this review are summarized in the infographic. The economic burden of cancer can be described using three broad categories:

• direct costs
• indirect costs
• psychosocial costs

Direct out-of-pocket costs

Direct out-of-pocket costs, one component of total direct costs, are incurred directly by patients and their families. Expenses include medications, childcare, transportation and parking, medical consultations, and more. Costs are even higher for children with cancer, for people with low incomes and without health insurance from an employer, and for people living in rural or remote areas.

Out-of-pocket costs pose a substantial economic burden to cancer patients and their families. A systematic literature review was conducted to identify studies that estimated the out-of-pocket cost burden faced by cancer patients and their caregivers. The study evaluated the literature and found evidence that cancer patients and caregivers spent 42% and 16% of their annual income on out-of-pocket expenses in low- and middle-income countries and HICs, respectively. Healthcare systems have an opportunity to improve the coverage of medical and non-medical costs for cancer patients to help alleviate this burden and ensure equitable access to care.

Indirect costs

Indirect costs include lost income, sick days, the cost for an employer to replace a worker, and reduced productivity. In fact, the overall productivity losses to the Canadian economy range from $75 million to $317 million per year. Also, self-employed patients face a greater loss of income compared to employed people.

The article “The indirect cost burden of cancer care in Canada: A systematic literature review” provides a comprehensive understanding of the indirect cost burden in Canada, by including non-labour market activity costs and by examining all relevant perspectives.

The review suggests that the indirect cost burden of cancer is considerable from the patient, caregiver, employer, and societal perspectives. These results also provide a strong case for the government and employers to ensure there are supports in place to help patients and caregivers buffer the impact of cancer so they can continue to engage in productive activities and enjoy leisure time.

Psychosocial costs

Psychosocial costs, or quality of life costs, include distress, pain, suffering and other negative experiences associated with cancer.

The article “The psychosocial cost burden of cancer: A systematic literature review” explores:

• the psychosocial cost burden associated with cancer
• the way in which studies measure psychosocial costs
• the impact of this burden

Conclusions of this study:

• Psychosocial costs make up two‐thirds of the total economic burden of cancer.  Given this, economic evaluations should account for psychosocial costs in the analysis to better inform decision‐
• Consistency in the approach to measuring psychosocial costs would help researchers and decision makers to better understand how pervasive the issue is for patients and families, as well as the impact in different populations.
• More support is needed to address the psychosocial cost burden faced by patients and their families.