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Italy - Evidence package
EFPIA Roundtables on Cancer
2017-05-11
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Content
Analysis of the
development in cancer
care in Italy based on
IHE:s comparator report
2016:4
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Key findings
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Cancer incidence is increasing; Italy is 3rd highest in
Europe.
Mortality has decreased with 23 % in Italy between 19952012 compared to -17% for overall Europe.
5-year survival has improved, Italy’s survival rate above
the European average.
The burden (measured in DALYs) of cancer disease has
overtaken cardiovascular disease.
Overall spend on health care below the average of the Big
EU countries(-21% in per capita terms) as well as for
medicines
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Key findings
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The total healthcare direct per capita expenditure of cancer is
somewhat lower than the European average (155 € compared to 169
€, -8%) and than other Big EU Countries (199 €, -21%).
All over the main EU countries, pharmaceutical expenditure for
oncology products amounts to 23% of the total healthcare
expenditure in cancer and can determine savings in the remaining
77%.
Total direct per capita expenditure of cancer have decreased since
2010 (-11%).
Italy is a pioneer in its implementation of Managed Entry Agreements
OECD health ministerial state the need to develop a system of health
outcomes and health system performance for all countries to learn
from best practice.
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BURDEN OF CANCER
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Increased incidence in line with European pattern
Large increases in all countries
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Cancer incidence in
Italy was 520 per
100,000 in 1995 and
597 per 100,000 in
2012 which is among
the highest in Europe
and represents a 15 %
increase.
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Cancer incidence in
Europe was 523 per
100,000 in 2012.
Cancer incidence cases per 100,000 inhabitants (crude rates, both sexes)
Notes: Hatched bars indicate that national estimates are based on regional data or based on neighboring countries.
Source: Steliarova-Foucher et al (2012), Ferlay et al (2013)
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Mortality decreases, Italy rates slightly below the
European average
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Male cancer mortality
in Italy was 260 per
100,000 in 1995 and
200 per 100,000 in
2012. This represents a
23 % decrease in
mortality rates.
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Male cancer mortality
overall in Europe was
270 per 100,000 in
1995 and 224 per
100,000 in 2012 which
is a 17 % decrease.
Male cancer mortality cases per 100,000 inhabitants (age-standardized rates)
Source: Bray et al (2002), Ferlay et al (2013)
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Survival has improved, Italy's survival rates are above
the European average
Increases in all countries between 1990-2007.
The survival rate improvement was larger in Italy than
for the EU average, between the time periods 19901994 and 2000-2007 (9 vs 8 percentage points)
5-year age-adjusted relative survival rates for all cancers in patients aged ≥15 years, 1990–2007
Notes: Hatched bars indicate that national estimates are based on regional data. Source: EUROCARE-3 to EUROCARE-5
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Cancer has overtaken cardiovascular disease in
terms of disease burden
9,000
DALY per 100,000 inhabitants
8,000
7,000
6,000
5,000
4,000
3,000
2,000
1,000
0
EU+2 2000
Italy 2000
Cancer
EU+2 2012
Cardiovascular
Source: WHO
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Italy 2012
Expenditure of cancer drugs per capita (in 2014 prices) is
increasing in Italy at a lower pace than in Europe
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Spending on cancer drugs
doubled from €19 to €38
(in 2014 prices) in Europe.
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Italy's cancer drugs
expenditure is growing
less, in percentage, than
the European average
between 2005-2014.
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Despite higher incidence of
the disease and the higher
costs of drugs, better
therapies lead to lower
total costs in recent years.
Notes: Data for EE, LV, LU, and EL only comprise retail sales. * The value for 2005 for IE is from 2006 and for PT from 2010.
Source: IMS Health MIDAS database
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€ 200
Total direct expenditure per capita have declined
since 2010 while costs due to mortality is steadily
declining
€ 175
€ 171
€ 175
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The economic burden of productivity
loss due to premature mortality in Italy
is steadily declining due to improved
patient outcomes. This trend is in line
with the European experience.
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Despite higher incidence of the disease
and the higher expenditure of drugs,
better therapies produced lower total
expenditure in Italy in recent years.
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Between 2010-2014, total healthcare
expenditure for cancer in absolute
values declined in Italy (-2%), while it
grew for the European average (+8%).
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In the same period the share of cancer
on total HC expenditure decreased in
Italy (-0.06 percentage points) while it
was stable for the EU average
€ 156
€ 150
€ 125
€ 100
€ 75
€ 102
€ 149
€ 97
€ 150
€ 95
€ 139
€ 116
€ 86
€ 105
€ 83
€ 50
€ 25
€0
direct
m-loss
1995
direct
m-loss
direct
2000
cost of cancer drugs
€ 40
€ 36
€ 21
m-loss
2005
direct
m-loss
2010
direct
m-loss
2014
other direct health costs
Notes: “direct” = direct health cost of cancer; “m-loss” = productivity loss due to
premature mortality from cancer. 2014 prices. No data on cost of drugs as share of
direct costs 1995-2000.
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Italy have lower cancer medicine expenditures and better
outcome in form of lower mortality loss than the big EU countries
Comparison of Italy and big EU countries, in per capita unadjusted €, 2014
Cancer medicine expenditure
Mortality loss
0%
-5%
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Italy´s expenditure in
cancer medicine was lower
than the average of the big
EU countries in 2014 (€40
vs €47 per capita).
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The mortality loss was €83
per capita for Italy and
€116,1 per capita for big
EU countries in 2014.
-10%
-15%
-15 %
-20%
-25%
-30%
-29 %
-35%
Notes: Mortality loss: economic burden of productivity loss due to premature mortality.
Big EU countries include: Germany, France, Spain and UK.
These are weighted after population size
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Per capita spending on cancer slightly below the
European average
Health spending on cancer: € 155
in Italy and €169 in Europe.
Large country variations
Cost of cancer per capita (2014)
Notes: Hatched bars indicate that the direct cost is estimated based on data from similar countries.
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