An analysis of the EUROCARE found that lower total national health expenditure (TNHE) was associated with shorter survival among patients with some types of myeloid neoplasms (MNs), according to a report published in the European Journal of Oncology.
The researchers also reported that 10-year relative excess risk of death (RER) was generally higher for patients in regions with lower TNHE.
EUROCARE-6 is a dataset in the EUROCARE study that is derived from 27 European countries of patients aged 15 or older diagnosed with an MN between 2001 and 2013. MNs included acute myeloid leukemia (AML), myeloproliferative neoplasms (MPNs), chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and myelodysplastic syndrome (MDS).
There were a total of 267,968 MN cases in the dataset, of which, 41.1% were AML, 32.2% were MPNs, 11.7% were CML, 6.8% were PV, 7.4% were ET, and 19.6% were MDS, and 4.4% were MDS/MPN.
Countries in the lowest TNHE quartile included Bulgaria, Croatia, Estonia, Latvia, Lithuania, Poland, and Slovakia. Countries in the highest TNHE quartile included Austria, Denmark, Germany, Norway, and Switzerland. The median follow-up was 13 years.
At 10 years, the age-standardized relative survival (ASRS) ranged from 61.2% for MPNs to 15.6% for AML. Within MPNs, the 10-year ASRS was 75.2% for ET, 70.9% for PV, and 52.5% for CML.
Countries in the lowest TNHE quartile demonstrated lower 10-year ASRS rates compared with countries in the highest quartile for AML, MPN, and MDS.
A similar trend was observed for 10-year RERs for most MNs, with higher RERs associated with lower TNHE quartile. For example, the lowest TNHE quartile was significantly associated with a greater 10-year RER for MPN (RER, 1.32; 95% CI, 1.30-1.35), AML (RER, 1.28; 95% CI, 1.25-1.31), and acute promyelocytic leukemia (RER, 1.42; 95% CI, 1.12-1.80).
The highest quartile was significantly associated with lower 10-year RER for MPN (RER, 0.80; 95% CI, 0.78-0.81) and AML (0.86; 95% CI, 0.84-0.88), but not some subtypes of AML and APL.
“TNHE is associated with geographical inequalities in MN prognosis,” the researchers concluded in their report. “Policy decisions on allocating economic resources are needed to reduce these differences.”