Background: In Australia, decision-making to determine government subsidisation of medical services and pharmaceuticals relies on estimates of patient populations that may benefit from the service/treatment. Estimates are generally provided by service/pharmaceutical sponsors to inform an application for subsidisation, leading to heterogeneity and limiting the ability to ensure efficiency and consistency in the distribution of health resources. Knowing how patient population sizes may change over time, and which subgroups are more likely to require care, can help determine resource and financial priorities.
Aim: The Cancer-Patient Population Projections (Cancer-PPP) project aims to provide detailed estimates of cancer burden developed independently from service providers and pharmaceutical sponsors. These estimates can inform future applications while reducing the burden on applicants, and build a more consistent and efficient health system. In the first stage of Cancer-PPP, we generated 5-year estimates of colorectal cancer (CRC) patient populations by age, sex, and stage of disease.
Methods: Cancer-PPP uses large scale epidemiological analyses, mathematical modelling, evidence reviews, health economics, and expert advice in oncology and public policy to consolidate and synthesise data on incidence, mortality, treatments, and costs. These data were used to estimate projected CRC patient numbers and treatment costs with the Daffodil Centre’s predictive modelling platform, Policy1.
Policy1-Bowel is a validated and calibrated microsimulation model of CRC in Australia. For this study, Policy1-Bowel incorporated the impact of the National Bowel Cancer Screening Program, as well as projected CRC incidence rates generated using age-period-cohort models, capturing increases in incidence attributable to risk factor exposure for people under 50. Estimates were generated by age, sex, year, and disease stage.
Results: Over 2023-2027, there would be an estimated 82,000 new CRC cases diagnosed and 23,000 CRC deaths. Treatment for CRC will cost the Australian health system $1.4 billion annually and require 470,000 hospital days. These results have been made available via an interactive data visualisation tool to inform health decision-making on an ongoing basis.
Conclusion: As the cancer patient base grows and treatment options become increasingly complex, the health system cost burden for CRC will increase significantly. These independently generated 5-year estimates will be used to inform future health technology assessments of CRC interventions, and ensure budget impact studies are consistent and less burdensome on applicants when guiding decision-making. In the next phase of Cancer-PPP, five-year estimates will be generated for breast and lung cancer, as well as melanoma, multiple myeloma, and cancers related to selected pan-tumour biomarkers.