BACKGROUND: There is a steady decline in cancer mortality in Western Europe (WE), but this trend is not so obvious in Central and Eastern Europe (CEE). One of the largest discrepancies between WE and CEE is the level of investment in cancer care. The objective of our analysis was to examine the correlation between mortality-to-incidence (M/I) ratio and expenditures on oncology drugs in CEE and WE. MATERIALS AND METHODS: This cross-sectional analysis was done on publicly available data. Data on expenditures for oncology drugs were obtained from QuintilesIMS, and data on M/I ratio from Globocan. The main outcome was mortality-to-incidence ratio, and the primary analysis was performed by Spearman's rank correlation. RESULTS: There is a large discrepancy in expenditure on oncology drugs per cancer case between WE and CEE, and within CEE. Average expenditure on oncology drugs per capita as well as per new cancer case was 2.5 times higher in WE than in CEE. Availability of oncology drugs was highest in Germany (100%), relatively similar in WE (average of 91%), but in CEE it ranged from 37% to 86%, with an average of 70%. Annual expenditures on all oncology drugs per new cancer case was significantly negatively correlated with the M/I ratio (Spearman's ρ = -0.90, p < .001). CONCLUSION: There is a financial threshold for oncology drugs per cancer case needed to increase survival. Based on significantly lower expenditures for oncology drugs in CEE in comparison with WE, more investment for drugs as well as better, more organized, value- oriented consumption is needed. IMPLICATIONS FOR PRACTICE: Cancer is not treated equally successfully in Western Europe (WE) and in Central and Eastern Europe (CEE). This study showed that success in treatment of cancer is associated with the amount of money invested in oncology drugs. CEE countries spend on average 2.5 times less than WE countries for oncology drugs per new cancer case. These findings should be used by health care providers and oncologists struggling for more resources and better, more organized, evidence-based allocation of these resources as well as better oncology outcomes.

Biometrika Healthcare Research Zagreb Croatia

Daily Chemotherapy Hospital Institute for Oncology and Radiology of Serbia Belgrade Serbia

Department of Breast Tumors Cancer Institute Prof Dr 1 Chiricuta Cluj Napoca Romania

Department of Medical Oncology Tumor Center Aarau Aarau Switzerland

Department of Medicine 1 Medical University of Vienna Austria

Department of Oncology Clinical Hospital Center Split School of Medicine University of Split Split Croatia

Department of Oncology St László Teaching Hospital Budapest Hungary

Department of Oncology University Hospital Motol Charles University Prague Czech Republic

Institute of Oncology Clinical Center University of Sarajevo Sarajevo Bosnia and Herzegovina

Institute University Clinic of Radiotherapy and Oncology Ss Cyril and Methodius University Skopje Macedonia

Medical University of Gdańsk Gdańsk Poland

National Hospital of Oncology Sofia Bulgaria

Oncology and Radiotherapy Clinic Clinical Centre of Montenegro Podgorica Montenegro

Oncology Division Department of Medicine Stanford University School of Medicine Stanford California USA

Oncology Institute University Hospital Center Mother Teresa Tirana Albania

University Clinic Golnik Golnik Slovenia

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