OBJECTIVE: To evaluate the cost-effectiveness of tertiary referral care for ovarian cancer patients in the Netherlands. METHODS: We collected clinical and registry data on 1077 newly diagnosed ovarian cancer patients treated from 1996-2003 in a random sample of Dutch hospitals. Decision modelling was used to compare the cost-effectiveness of treatment in general hospitals, semi-specialized hospitals, and tertiary care centers. The actual direct medical costs of ovarian cancer treatment were evaluated. Long-term outcomes in terms of costs, quality-adjusted life-years (QALYs), and incremental costs per QALY gained were estimated. To assess uncertainty, multivariable sensitivity analyses and scenario analyses were performed. RESULTS: Treatment of ovarian cancer patients in semi-specialized hospitals costs on average euro882 more than in general hospitals (95% confidence interval -720 to 2462) and yields 0.12 additional QALYs (95% CI 0.02 to 0.22), resulting in an incremental cost-effectiveness ratio (ICER) of euro7135. Patients treated in tertiary care centers incurred again higher costs (euro10,591, 95% CI 8757 to 12,480) and also higher QALYs (0.10, 95% CI 0 to 0.21), resulting in an ICER of euro102,642 compared to semi-specialized hospitals. If the optimal debulking rate in tertiary care centers would increase to 70%, costs could drop below euro30,000 per QALY. CONCLUSION: Current treatment of ovarian cancer patients in semi-specialized hospital settings is a cost-effective strategy, while treatment in tertiary care centers becomes only cost-effective when better surgical results would be achieved.
OBJECTIVE: To evaluate the cost-effectiveness of tertiary referral care for ovarian cancerpatients in the Netherlands. METHODS: We collected clinical and registry data on 1077 newly diagnosed ovarian cancerpatients treated from 1996-2003 in a random sample of Dutch hospitals. Decision modelling was used to compare the cost-effectiveness of treatment in general hospitals, semi-specialized hospitals, and tertiary care centers. The actual direct medical costs of ovarian cancer treatment were evaluated. Long-term outcomes in terms of costs, quality-adjusted life-years (QALYs), and incremental costs per QALY gained were estimated. To assess uncertainty, multivariable sensitivity analyses and scenario analyses were performed. RESULTS: Treatment of ovarian cancerpatients in semi-specialized hospitals costs on average euro882 more than in general hospitals (95% confidence interval -720 to 2462) and yields 0.12 additional QALYs (95% CI 0.02 to 0.22), resulting in an incremental cost-effectiveness ratio (ICER) of euro7135. Patients treated in tertiary care centers incurred again higher costs (euro10,591, 95% CI 8757 to 12,480) and also higher QALYs (0.10, 95% CI 0 to 0.21), resulting in an ICER of euro102,642 compared to semi-specialized hospitals. If the optimal debulking rate in tertiary care centers would increase to 70%, costs could drop below euro30,000 per QALY. CONCLUSION: Current treatment of ovarian cancerpatients in semi-specialized hospital settings is a cost-effective strategy, while treatment in tertiary care centers becomes only cost-effective when better surgical results would be achieved.
Authors: Renee A Cowan; Roisin E O'Cearbhaill; Ginger J Gardner; Douglas A Levine; Kara Long Roche; Yukio Sonoda; Oliver Zivanovic; William P Tew; Evis Sala; Yulia Lakhman; Hebert A Vargas Alvarez; Debra M Sarasohn; Svetlana Mironov; Nadeem R Abu-Rustum; Dennis S Chi Journal: Ann Surg Oncol Date: 2015-10-28 Impact factor: 5.344
Authors: Caroline S Clarke; Mariya Melnychuk; Angus I G Ramsay; Cecilia Vindrola-Padros; Claire Levermore; Ravi Barod; Axel Bex; John Hines; Muntzer M Mughal; Kathy Pritchard-Jones; Maxine Tran; David C Shackley; Stephen Morris; Naomi J Fulop; Rachael M Hunter Journal: Appl Health Econ Health Policy Date: 2022-07-22 Impact factor: 3.686
Authors: Edward Morcos; Christian Falconer; Emilie Toresson Grip; Kirk Geale; Katarina Hellgren; Georgios Poutakidis; Daniel Altman Journal: Int Urogynecol J Date: 2021-02-26 Impact factor: 2.894