Costs Associated with Diffuse Large B-Cell Lymphoma Patient Treatment in a Canadian Integrated Cancer Care Center

Autor: Douglas J. Demetrick, Konrad Fassbender, Robert C. Lee, Denise Zou, Douglas A. Stewart, Lisa M. DiFrancesco
Rok vydání: 2008
Předmět:
Male
drug combinations
medicine.medical_specialty
Palliative care
Total cost
Cost-Benefit Analysis
neoplasms
Context (language use)
Cancer Care Facilities
CHOP
chemotherapy
Alberta
Resource Allocation
Antibodies
Monoclonal
Murine-Derived
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Intensive care medicine
Cyclophosphamide
health care economics and organizations
Aged
Retrospective Studies
Aged
80 and over
business.industry
Medical record
Health Policy
Public Health
Environmental and Occupational Health
Antibodies
Monoclonal
economics
Health Care Costs
Middle Aged
medicine.disease
Transplantation
R-CHOP
Doxorubicin
Vincristine
Prednisone
microcosting
Female
Rituximab
Lymphoma
Large B-Cell
Diffuse
business
health-care costs
Diffuse large B-cell lymphoma
medicine.drug
Zdroj: Value in Health. 11(2):221-230
ISSN: 1098-3015
DOI: 10.1111/j.1524-4733.2007.00227.x
Popis: Objective The objective of this study was to provide a detailed comparative microcosting analysis for two cancer treatment pathways to contribute evidence for resource allocation and operational decision-making in a Canadian cancer care context. Methods We estimated direct medical costs (in 2004 CAN$) of the entire pathway of care for diffuse large B-cell lymphoma (DLBCL) patients in a large Canadian cancer treatment center. Patient samples were defined as those who received R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone; n=85) or CHOP (i.e., without rituximab; n=86) as first-line treatment. All subsequent treatments including palliative care for these patient samples were assessed. Hospitalization costs and unit costs of medical resources were collected from integrated medical organizations. Individual patient resource consumption was assessed via medical chart review. Results For first-line treatment, drug cost was the largest contributor to total cost, followed by hospitalization cost. Rituximab was the largest contributor to mean cost differences between R-CHOP and CHOP treatments. For treatments subsequent to first-line treatment, no significant cost differences were found. Hospitalization and transplantation costs were the two largest constituents of total costs subsequent to first-line treatment, followed by drug cost. Patients with advanced stage disease cost significantly more than patients with limited stage disease. Conclusion This is the first detailed microcosting study that has employed consistent local data to estimate total medical costs for DLBCL patients in Canada. This information is useful for resource allocation planning and operational decisions, because it provides more substantive, relevant evidence as compared to aggregated, literature or extrapolated information.
Databáze: OpenAIRE
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