The treatment of breast cancer and retinal diseases, including age-related macular degeneration and diabetic macular oedema, cost the Polish economy nearly PLN 27.5 billion in 2024. According to reports prepared by EconMed Europe, direct spending by the National Health Fund represents only a fraction of the real burden of these diseases. In the case of breast cancer, NFZ expenditure accounted for only 20 percent of total costs, while in the case of retinal diseases it represented just 8 percent.
Experts argue that the public debate too often focuses only on direct healthcare expenditure, while overlooking costs borne by patients, families, employers and the wider economy. These hidden costs include sickness absence, reduced productivity, informal care, loss of independence and the withdrawal of patients or caregivers from the labour market.
“Current indicators, when we talk about the costs of medical technologies and diseases, unfortunately do not fully reflect reality. We mainly look at direct costs, at how much the payer, namely the National Health Fund, spends, which is of course reasonable. But we do not look at a whole range of other indirect costs related to lost productivity due to illness. We do not look at how much patients spend out of pocket, how much we as an economy lose because of disease, and how much we could gain if we treated these diseases effectively and efficiently,” says Dr Michał Seweryn, Vice-President of EconMed Europe, in an interview with Newseria.
EconMed Europe prepared two reports calculating the social costs of breast cancer and retinal diseases, including age-related macular degeneration and diabetic macular oedema, known as AMD and DME. Both reports are available on the website of the Public Health Foundation.
According to the report “Systemic analysis of oncological care for breast cancer patients in Poland”, more than 231,000 women in Poland were treated for breast cancer in 2024. The total cost of the disease was estimated at PLN 18 billion. Of this amount, direct costs covered by the National Health Fund reached PLN 3.58 billion, or 20 percent, while costs borne directly by patients amounted to PLN 1.38 billion, or 7 percent.
The second report, “Systemic analysis of treatment of patients with retinal diseases – AMD and DME in Poland”, shows that the number of patients in 2024 slightly exceeded 339,000. The total cost of treating this patient population was more than PLN 9.4 billion. Direct costs borne by patients, including private medical expenses and costs related to visits to treatment centres, exceeded PLN 750 million, or 8 percent. NFZ expenditure, including drug programmes and hospital treatment, was similar, at PLN 767 million, also around 8 percent.
“The most surprising thing is that, although in such diseases we spend a great deal of money on treatment and very expensive medicines, it turns out that payer expenditure accounts for only a small part of the costs borne by society,” stresses Dr Michał Seweryn. “In the case of breast cancer, 73 percent of the costs are indirect costs, meaning those not related to payer expenditure. In the case of retinal diseases such as AMD and DME, indirect costs amounted to almost 85 percent.”
According to Dr Jakub Gierczyński, a member of the Presidium of the Expert Council at the Patient Rights Ombudsman, the current approach to healthcare costs is too narrow.
“We focus exclusively on the costs borne by the National Health Fund. We do not even take into account the costs of the Social Insurance Institution, which also uses public funds to cover sickness absence or disability pensions resulting from ineffective action at the level of prevention or curative medicine,” he says.
In the category of indirect costs, the authors of the reports included short- and long-term absence from the labour market, reduced productivity at work, unpaid work and informal care. In the case of AMD and DME, these costs totalled PLN 7.9 billion. In the case of breast cancer, they reached PLN 13.3 billion.
“When we look from the perspective of social costs, we examine how much we lose because patients are not working, because they are absent or have to give up employment. We look at whether caregivers bear additional costs, whether they have to take time off work or reduce their working hours, and whether patients lose money because of additional expenses generated by the disease,” explains Dr Michał Seweryn.
The scale of the problem is clearly visible in the case of breast cancer. Among professionally active breast cancer patients, 66 percent gave up work because of the disease. Those who continued to work used sick leave for an average of 31 days per year, while their average productivity fell to 58 percent. Around half of patients used part of their annual leave for treatment, and 13 percent had to devote more than 19 days per year to this purpose.
In the case of AMD and DME, where the peak incidence occurs between the ages of 60 and 75, every third working patient reduced their working time by an average of 13 hours per week. In addition, 37 percent of patients indicated frequent visits to treatment centres as one of the difficulties they faced.
“Every zloty spent by the National Health Fund on treatment means three zlotys spent by patients and their families. We should look at disease and its treatment not only through the prism of expenditure, but rather as an investment. By treating diseases better and more effectively, we avoid very large costs,” says the Vice-President of EconMed Europe.
This perspective is also important from the point of view of personal finance. Dominika Nawrocka, personal finance expert and founder of the Kobieta i Pieniądze platform, argues that health and financial security should not be treated as separate areas.
“Unfortunately, Poles still need to be convinced that investing in health and personal finances is an investment with a high rate of return. The concept of financial health has emerged, and I think it answers very well the question of whether we should focus on health or finances. We should focus on both,” she says.
According to McKinsey & Company data from 2020, every dollar invested in healthcare generates an expected economic return of between two and four dollars. This means that better prevention, earlier diagnosis and effective treatment should be seen not only as medical priorities, but also as economic policy tools.
“When we think about the next generations, it is essential to look at investments in health innovation from the perspective of social value. Let me remind you that in 1950, life expectancy for women was 62 years and for men 56 years. In 2025, it is 82 and 76 years respectively,” says Dr Jakub Gierczyński. “This is a success of medicine and lifestyle changes, among other factors. We must therefore maintain access to medicine at the highest European level so that Polish society has a chance to avoid excess deaths and live with chronic disease in a way as close as possible to normal life.”
Experts emphasise that innovation in medicine is important, but it must be accompanied by stronger prevention. Early diagnosis and more effective treatment can reduce the long-term burden on patients, families and the state. This is particularly important in a country facing demographic decline.
“In Poland, 240,000 children are born each year, while deaths amount to around 400,000. This means that 160,000 more people die than are born. We are therefore inevitably moving towards depopulation, meaning a decline in the number of Poles living in Poland. If we do not improve the health of children and young people, people of working age and seniors, this process will continue,” warns Dr Gierczyński.
He adds that Poland still has significant room for improvement in preventable mortality. According to him, if Poland reached the EU average in deaths avoidable through treatment and prevention, 36,000 deaths could be avoided.
The reports prepared by EconMed Europe show that the real cost of disease is much higher than public healthcare expenditure alone. Breast cancer and retinal diseases affect not only the health of hundreds of thousands of patients, but also their income, employment, family life and independence. For the economy, this translates into billions of zlotys in lost productivity and additional social costs.
The conclusion is clear: healthcare spending should increasingly be treated as an investment, not merely as a cost. More effective treatment, better organisation of care, broader access to modern therapies and stronger prevention can reduce not only the burden on patients, but also the financial losses borne by society as a whole.
