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Heidelberg Health Economic Summer School (HESS)

Due to the ongoing COVID-19 pandemic, the Heidelberg Health Econonomic Summer School has been rescheduled for next year. Hosted by the German Cancer Research Center's Division of Health Economics, the summer school will introduce health economics concepts and address practical issues faced by health care decision makers. It also includes an advanced module featuring an in-depth review of the strengths and limitations of the conventional approaches. We hope to see you there in 2022!

Additional News

Recent Publications:

The Underestimated Financial Burden of Cancer

After a cancer diagnosis, patients often face long treatment durations. The therapies not only result in additional expenses, but also in many patients being unable to work for long periods of time. Researchers from our division have examined the extent of income loss for German patients after a cancer diagnosis. Analyzing data from a the Socio-Economic Panel—one of the largest and most comprehensive household surveys in Germany—they determined within the first year of a cancer diagnosis, patients experienced an average drop in their salaries or income from 26-28%. Working hours were reduced by an average of 24%. In comparison, those diagnosed with cancer after reaching retirement age did not suffer loss in the level of their retirement benefits.

"For working people in particular, a cancer illness often means a considerable financial challenge due to loss of income," says study author Diego Hernandez. He notes that for those affected, the loss of income and reduced working hours also have a noticeable impact on the level of future pensions.

Division director and co-author, Michael Schlander, states: "In addition, patients often have to pay considerable co-payments, for example for necessary medications, accompanying psychotherapies, patient transport and medical devices, out of their own pockets. Even in Germany, with its broad and comprehensive health insurance ... the financial risks associated with cancer for those affected and their families should not be underestimated."

The authors recommend further research to identify particular groups that might be more vulnerable to socioeconomic effects of cancer.

D. Hernandez, M. Schlander:
Income loss after a cancer diagnosis in Germany: An analysis based upon the socio-economic panel survey.
Cancer Medicine, first published online 10 May 2021.
DOI: 10.1002/cam4.3913

DKFZ press release (in German):


Risk-basis: A Cost-effective Approach to Breast Cancer Screening

Mammography screening programs are part of cancer prevention in many countries; however, eligibility is determined by age—over age 50 in Germany. A new systematic review from researchers at the Health Economics Division of DKFZ has shown evidence that personalized, risk-based mammography screening could achieve higher health gains at comparable costs.

Previous studies have indicated that particular risk factors, such as breast density, familial risk, lifestyle and genetic factors, among others, influence the probability of developing breast cancer. This has raised the question of whether women at higher risk might benefit from earlier or more frequent screenings; likewise, if it is sensible for woman at lower risk to undergo less frequent screenings.

The authors compared the cost-effectiveness of different screening programs. They found that programs in which women at lower risk were screened less frequently, but women at higher risk were screened more frequently, proved to be more cost-effective than purely age-based screening (or no screening at all). This means that for the same cost, risk-based screening can achieve a higher health gain relative to the group of all women screened.

"In our evaluation, personalized screening appeared to be an economically efficient alternative to purely age-based breast cancer screening," explains co-author Michael Schlander. However, he clarifies that a conclusive assessment is not yet possible due to the heterogeneity of the individual studies evaluated. Principal investigator Shah Khan adds: "Further studies are necessary before age-based screening is replaced by another method. This should also include new technologies, such as 3D mammography or special MRI examination procedures."

S. A. Khan, K. V. Hernandez-Villafuerte, M. T. Muchadeyi, M. Schlander:
Cost-effectiveness of risk-based breast cancer screening: A systematic review.
International Journal of Cancer, first published online 12 April 2021.
DOI: 10.1002/ijc.33593.

DKFZ press release (in German):

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