Home‐based chemotherapy for stage III colon cancer patients in Thailand: Cost‐utility and budget impact analyses

Autor: Nopakan Wannakansophon, Nattanichcha Kulthanachairojana, Suwannee Sirilerttrakul, Phichai Chansriwong, Nintita Sripaiboonkij Thokanit, Suthira Taychakhoonavudh
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Colorectal cancer
Cost-Benefit Analysis
home‐based chemotherapy
Leucovorin
cost‐utility analysis
Time horizon
lcsh:RC254-282
03 medical and health sciences
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Radiology
Nuclear Medicine and imaging
Adverse effect
Reimbursement
health care economics and organizations
Original Research
Retrospective Studies
Cost–utility analysis
business.industry
Self-Management
Medical record
Clinical Cancer Research
Retrospective cohort study
Middle Aged
Prognosis
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Home Care Services
portable infusion pump
Bevacizumab
Oxaliplatin
Regimen
030104 developmental biology
Oncology
colon cancer
030220 oncology & carcinogenesis
Colonic Neoplasms
Emergency medicine
Female
Fluorouracil
business
Follow-Up Studies
Zdroj: Cancer Medicine, Vol 10, Iss 3, Pp 1027-1033 (2021)
Cancer Medicine
ISSN: 2045-7634
Popis: Home‐based chemotherapy (HC) is a new treatment alternative to hospital‐based chemotherapy treatment (IP) and is administered via portable intravenous pumps at the patient's home. HC reduces the demand for inpatient bed capacity in hospitals and reduces the cost of an infusion. This study takes a societal perspective while conducting the cost‐utility and budget impact analyses (BIA) of HC and IP with an mFOLFOX6 regimen on patients with stage III colon cancer. We conducted a cost‐utility analysis with a 6‐month time horizon. The parameter inputs for the model were gathered from a retrospective cohort study on patients diagnosed with stage III colon cancer at Ramathibodi Hospital, Bangkok. The resource usage of HC and IP was determined based on medical records. The per‐unit direct medical, home health service, and adverse events (AE) management costs were gathered from the standard cost list. The health outcome of treatment was measured in terms of quality‐adjusted life years. Disutility related to AE was calculated. We conducted a sensitivity analysis for the uncertainty results and performed BIA based on the societal perspective on a 1‐year time horizon. HC provided a cost‐saving of $1,513.37 per patient for the period of treatment. Thus, assuming 526 patients per year, the use of HC could achieve a cumulative annual cost‐saving of $828,436. HC is a cost‐saving strategy compared to IP for stage III colon cancer treatment. We recommend that the service reimbursement should include national standardization in chemotherapy regimens as well as practice guidelines and protocols to prevent serious AEs.
Home‐based chemotherapy is a cost‐saving strategy compared to hospital‐based chemotherapy for stage III colon cancer treatment. We recommend that the service reimbursement should include national standardization in chemotherapy regimens as well as practice guidelines and protocols to prevent serious adverse events.
Databáze: OpenAIRE
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