Financial burden of prostate cancer in the Iranian Population: a cost of illness and financial risk protection analysis

Background: Prostate cancer is the second most common cancer in males worldwide and the third most common among Iran’s male population. However, there is a lack of evidence regarding its direct and indirect costs in low and middle-income countries. This study intends to bridge the gap using a cost of illness approach, assessing the costs of prostate cancer from the perspectives of patients, society, and the insurance system. Methods: 297 patients were included in the study. Data for two months periods were obtained from patients registered at two hospital (Tabriz, Tehran), Iran in 2017. We applied a prevalence-based, bottom-up approach to assess the costs of the illness. The sensitivity analyses were performed using a probabilistic approach. We used the World Health Organization methods to measure the prevalence and investigate the determinants of catastrophic and impoverishing health expenditures. Results: We determined the total costs of the disease for the patients to be IRR 6.8E+07 (PPP $ 5244.44). Total costs of the disease from the perspective of the society amounted to IRR 7E+11 (PPP $ 5.4E+07). Insurance companies expended IRR 2E+07 (PPP $ 1558.8) per patient. Our findings show that 31% of the patients incurred catastrophic health expenditure due to the disease. 5.44% of the patients were impoverished due to the costs of this cancer. Conclusion: We found an alarmingly high prevalence of catastrophic health expenditures among prostate cancer patients. In additional the prostate cancer puts a substantial burden on both the patients and the society.