When is Cancer Care Cost-Effective? A Systematic Overview of Cost-Utility Analyses in Oncology

被引:120
作者
Greenberg, Dan [1 ,2 ]
Earle, Craig [3 ]
Fang, Chi-Hui [1 ]
Eldar-Lissai, Adi [4 ]
Neumann, Peter J. [1 ]
机构
[1] Tufts Med Ctr, Ctr Evaluat Value & Risk Hlth, Inst Clin Res & Hlth Policy Studies, Boston, MA 02111 USA
[2] Ben Gurion Univ Negev, Dept Hlth Syst Management, IL-84105 Beer Sheva, Israel
[3] Sunnybrook Hlth Sci Ctr, Inst Clin Evaluat Sci, Toronto, ON M4N 3M5, Canada
[4] Univ Rochester, Dept Community & Prevent Med, Sch Med & Dent, Rochester, NY USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2010年 / 102卷 / 02期
关键词
METASTATIC COLORECTAL-CANCER; UNITED-STATES; DRUGS; MEDICARE; LIFE; INTERVENTIONS; CHEMOTHERAPY; SERVICES; QUALITY; ENGLAND;
D O I
10.1093/jnci/djp472
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
New cancer treatments pose a substantial financial burden on health-care systems, insurers, patients, and society. Cost-utility analyses (CUAs) of cancer-related interventions have received increased attention in the medical literature and are being used to inform reimbursement decisions in many health-care systems. We identified and reviewed 242 cancer-related CUAs published through 2007 and included in the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org). Leading cancer types studied were breast (36% of studies), colorectal (12%), and hematologic cancers (10%). Studies have examined interventions for tertiary prevention (73% of studies), secondary prevention (19%), and primary prevention (8%). We present league tables by disease categories that consist of a description of the intervention, its comparator, the target population, and the incremental cost-effectiveness ratio. The median reported incremental cost-effectiveness ratios (in 2008 US $) were $27000 for breast cancer, $22000 for colorectal cancer, $34500 for prostate cancer, $32000 for lung cancer, and,$48000 for hematologic cancers. The results highlight the many opportunities for efficient investment in cancer care across different cancer types and interventions and the many investments that are inefficient. Because we found only modest improvement in the quality of studies, we suggest that journals provide specific guidance for reporting CUA and assure that authors adhere to guidelines for conducting and reporting economic evaluations.
引用
收藏
页码:82 / 88
页数:7
相关论文
共 36 条
[1]  
[Anonymous], 1996, COST EFFECTIVENESS H, DOI DOI 10.1093/OSO/9780195108248.001.0001
[2]  
[Anonymous], 2008, Cancer facts figures 2008
[3]  
[Anonymous], 2008, COST EFFECT RESOUR A, DOI DOI 10.1186/1478-7547-6-9
[4]   Costs of cancer care: A view from the centers for Medicare & Medicaid services [J].
Bach, Peter B. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (02) :187-190
[5]   Limits on Medicare's Ability to Control Rising Spending on Cancer Drugs [J].
Bach, Peter B. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (06) :626-633
[6]   Bias in published cost effectiveness studies: systematic review [J].
Bell, CM ;
Urbach, DR ;
Ray, JG ;
Bayoumi, A ;
Rosen, AB ;
Greenberg, D ;
Neumann, PJ .
BMJ-BRITISH MEDICAL JOURNAL, 2006, 332 (7543) :699-701
[7]  
BERENSON A, 2005, NY TIMES 0712
[8]   Providing guidance to the NHS: The Scottish Medicines Consortium and the National Institute for Clinical Excellence compared [J].
Cairns, J .
HEALTH POLICY, 2006, 76 (02) :134-143
[9]   Does preventive care save money? Health economics and the presidential candidates [J].
Cohen, Joshua T. ;
Neumann, Peter J. ;
Weinstein, Milton C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (07) :661-663
[10]  
Drummond MF, 2005, Methods for The Economic Evaluation of Health Care Programmes