Economic evaluation of four follow-up strategies after curative treatment for breast cancer: Results of an RCT
| Autor: | Alphons G.H. Kessels, J. K. S. Nuytinck, C. Haekens, A. Lenssen, Carmen D. Dirksen, Ph Lambin, Y. E. A. van Riet, M. Thuring, Luc J. E. E. Scheijmans, P. Falger, P. Hupperets, S.J. Brenninkmeijer, F.W.C. van der Ent, Adri C. Voogd, Liesbeth J. Boersma, J. Verkeyn, B. Gijsen, Merel Kimman |
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| Přispěvatelé: | RS: CAPHRI School for Public Health and Primary Care, Radiotherapie, Health Services Research, MUMC+: KIO Kemta (9), Epidemiologie, Medische Psychologie, Interne Geneeskunde, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Cost-Benefit Analysis Breast Neoplasms Nursing law.invention Breast cancer Randomized controlled trial law Surveys and Questionnaires Outcome Assessment Health Care Health care medicine Humans health care economics and organizations Aged Gynecology Cost–benefit analysis business.industry Follow-up Psychosocial support Middle Aged medicine.disease Economic evaluation Telemedicine Quality-adjusted life year Models Economic Breast care nurse Oncology Curative treatment Emergency medicine Telephone service Female Quality-Adjusted Life Years Breast disease business Delivery of Health Care Follow-Up Studies |
| Zdroj: | European Journal of Cancer, 47(8), 1175-1185. ELSEVIER SCI LTD |
| ISSN: | 0959-8049 |
| DOI: | 10.1016/j.ejca.2010.12.017 |
| Popis: | Background An economic evaluation was performed alongside a randomised controlled trial (ISRCTN 74071417) investigating the cost-effectiveness of nurse-led telephone follow-up instead of hospital visits, and of a short educational group programme (EGP) in the first year after breast cancer treatment. Method This economic evaluation ( n = 299) compared the one-year costs and the effects of four follow-up strategies: (1) hospital follow-up; (2) nurse-led telephone follow-up; (3) hospital follow-up plus EGP; and (4) nurse-led telephone follow-up plus EGP. Costs were measured using cost diaries and hospital registrations. Quality-adjusted life years (QALYs) were measured using the EQ-5D. Outcomes were expressed in incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves. Results Hospital follow-up plus EGP yielded most QALYs (0.776), but also incurred the highest mean annual costs (€4914). The ICER of this strategy versus the next best alternative, nurse-led telephone follow-up plus EGP (0.772 QALYs and €3971), amounted to €235.750/QALY. Hospital and telephone follow-up without EGP both incurred higher costs and less QALYs than telephone follow-up plus EGP and were judged inferior. Hospital follow-up plus EGP was not considered cost-effective, therefore, telephone follow-up plus EGP was the preferred strategy. The probability of telephone follow-up plus EGP being cost-effective ranged from 49% to 62% for different QALY threshold values. Secondary and sensitivity analyses showed that results were robust. Conclusion Nurse-led telephone follow-up plus EGP seems an appropriate and cost-effective alternative to hospital follow-up for breast cancer patients during their first year after treatment. |
| Databáze: | OpenAIRE |
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