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In high-income countries the public policy consensus is that costs of delivering high-quality equitable cancer care present an increasing challenge to national budgets. In the U.S. alone it is estimated cancer care expenditures in 2020 will be 157 billion dollars. The increase is being driven by a number of factors including technological innovation, rising costs of medical and hospital care, expensive therapeutics and an increase in the proportion of individuals susceptible to malignancy as the population ages. In this article we review what factors are informing and influencing the political debate on cancer economics across Europe and North America.

We have undertaken a comprehensive analysis of the literature and supplemented this with key informant interviews within each region. An important theme is the increasing role of individual patients, organisations and physicians in advocating for greater access to and …