Comparison of the cost of illness of primary liver cancer between Japan and Taiwan
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RESEARCH
Open Access
Comparison of the cost of illness of primary liver cancer between Japan and Taiwan Yinghui Wu1, Kunichika Matsumoto2, Ya-Mei Chen3, Yu-Chi Tung3, Tzu-Ying Chiu4 and Tomonori Hasegawa2*
Abstract Background: Primary liver cancer (PLC) is the fifth and second leading cause of death in Japan and Taiwan, respectively. The aim of this study was to compare the economic burden of PLC between the two countries using the cost of illness (COI) method and identify the key factors causing the different trends in the economic burdens of PLC. Materials and methods: We calculated the COI every 3 years using governmental statistics of both countries (1996–2014 data for Japan and 2002–2014 data for Taiwan). The COI was calculated by summing the direct costs, morbidity costs, and mortality costs. We compared the COIs of PLC in both countries at the USD-based cost. The average exchange rate during the targeted years was used to remove the impact of foreign exchange volatility. Results: From 1996 to 2014, the COI exhibited downward and upward trends in Japan and Taiwan, respectively. In Japan, the COI in 2014 was 0.70 times the value in 1996, and in Taiwan, the COI in 2014 was 1.16 times greater than that in 1996. The mortality cost was the greatest contributor in both countries and had the largest contribution ratio to the COI increase in Japan. However, the direct cost in Taiwan had the largest contribution ratio to the COI decrease. Conclusions: To date, the COI of PLC in Japan has continuously decreased, whereas that in Taiwan has increased. Previous health policies and technological developments are thought to have accelerated the COI decrease in Japan and are expected to change the trend of COI of PLC, even in Taiwan. Keywords: Cost of illness, Health policy, Liver neoplasms, Medical economics, Public health
Background Primary liver cancer (PLC; International Disease Classification 10 code C22) is an important disease in Asia. PLC is the fifth leading cause of death (the fourth among males and the sixth among females) in Japan [1] and the second leading cause of death (the second among both males and females) in Taiwan [2]. Most cases of PLC are caused by chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection [3–5]. PLC caused by chronic HCV infection is predominant in Japan, whereas HBV * Correspondence: [email protected] 2 Department of Social Medicine, Toho University School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo 143-8540, Japan Full list of author information is available at the end of the article
infection is the more predominant cause of PLC in Taiwan [6, 7]. Although PLC is an important cause of death, to date, few studies have attempted to estimate the total economic burden of PLC or other liver diseases in both countries. Several studies have assessed the economic burden of liver diseases in East Asian countries [8–11]; however, only our studies have investigated the burden in Japan [12, 13]. Moreover, no studies have examined the burden of liver diseases in Taiwan.
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