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The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years)

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 14234

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Special Issue Editors

Dr. Katharina Merollini

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Guest Editor

Sunshine Coast Health Institute, School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
Interests: cancer survivorship; cancer prevention; economic evaluations; decision-analytic modelling; cost analyses; financial toxicity
Special Issues, Collections and Topics in MDPI journals

Dr. Emily Callander

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Guest Editor

Menzies Health Institute, Griffith University, QLD 4122 Queensland, Australia
Interests: obstetrics and gynecology; pediatrics; reproduction; inequality; health care administration; health economics

Dr. Louisa Gordon

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Guest Editor

Health Economics group, QIMR Berghofer, QLD 4006 Queensland, Australia
Interests: economic evaluation; decision-analytic modelling; cancer interventions; cost-analyses; financial toxicity

Special Issue Information

Dear Colleagues,

Cancer has long become a global health issue and we expect the annual cancer incidence to reach 29.3 million worldwide by 2040 [Cancer Atlas, 2019]. Medical advances in early detection, treatment, and survivorship care continue to enhance patient outcomes and the probability of survival. Many people with a history of cancer require ongoing medical care due to chronic health conditions and late adverse effects that place a considerable strain on individuals, families, communities, health care providers, and governments. Long-term outcomes of cancer survivors past 5 years since diagnosis are under-researched and the economic impact is uncertain. Health economics research is the ideal platform to measure the long-term economic burden of cancer survivors from the patient, healthcare and societal perspectives, to aid decision-making, optimize care and use scarce health care resources responsibly.

For this Special Issue ‘Economic Impact and Cost-Effectiveness Evaluations in Long-term Cancer Survivorship (>5yrs)’ we would like to invite high-quality health economics research from a range of topics focusing on long-term outcomes beyond the initial diagnosis and treatment for cancer, such as:

Health system costs and health services use
Financial burden for patients, their families, and carers
Economic evaluations, cost analyses, cost-effectiveness studies, economic modeling
Productivity and employment
Innovative long-term care models / economic impact of support services and programs
Prevention of secondary cancer (e.g., screening, exercise programs)
Research focused on specific age group (pediatric, adolescent, adult, elderly)
Literature reviews

Dr. Katharina Merollini
Dr. Louisa Gordon
Dr. Emily Callander
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Cancer
survivorship
economic evaluations
cost analysis
cost-effectiveness
economic burden
patient outcomes
financial toxicity
health services research

Published Papers (6 papers)

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Research

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13 pages, 1700 KiB

Open AccessArticle

Cost-Effectiveness of PET/CT Surveillance Schedules to Detect Distant Recurrence of Resected Stage III Melanoma

by Mbathio Dieng, Robin M. Turner, Sarah J. Lord, Andrew J. Einstein, Alexander M. Menzies, Robyn P. M. Saw, Omgo E. Nieweg, John F. Thompson and Rachael L. Morton

Int. J. Environ. Res. Public Health 2022, 19(4), 2331; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19042331 - 17 Feb 2022

Cited by 1 | Viewed by 1662

Abstract

Objective: To estimate the cost-effectiveness of three surveillance imaging strategies using whole-body positron emission tomography (PET) with computed tomography (CT) (PET/CT) in a follow-up program for adults with resected stage III melanoma. Methods: An analytic decision model was constructed to estimate the costs and benefits of PET/CT surveillance imaging performed 3-monthly, 6-monthly, or 12-monthly compared with no surveillance imaging. Results: At 5 years, 3-monthly PET/CT surveillance imaging incurred a total cost of AUD 88,387 per patient, versus AUD 77,998 for 6-monthly, AUD 52,560 for 12-monthly imaging, and AUD 51,149 for no surveillance imaging. When compared with no surveillance imaging, 12-monthly PET/CT imaging was associated with a 4% increase in correctly diagnosed and treated distant disease; a 0.5% increase with 6-monthly imaging and 1% increase with 3-monthly imaging. The incremental cost-effectiveness ratio (ICER) of 12-monthly PET/CT surveillance imaging was AUD 34,362 for each additional distant recurrence correctly diagnosed and treated, compared with no surveillance imaging. For the outcome of cost per diagnostic error avoided, the no surveillance imaging strategy was the least costly and most effective. Conclusion: With the ICER for this strategy less than AUD 50,000 per unit of health benefit, the 12-monthly surveillance imaging strategy is considered good value for money. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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10 pages, 1116 KiB

Open AccessArticle

Quantifying the Costs to Different Funders over Five-Years for Women Diagnosed with Breast Cancer in Queensland, Australia: A Data Linkage Study

by Daniel Lindsay and Emily Callander

Int. J. Environ. Res. Public Health 2021, 18(24), 12918; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182412918 - 08 Dec 2021

Viewed by 2097

Abstract

Individuals diagnosed with breast cancer have the highest rates of survival among all cancer types. Due to high survival, the costs of breast cancer to different healthcare funders are of interest. This study aimed to describe the cost to public hospital and private health funders and individuals due to hospital and emergency department (ED) admissions, as well Medicare items and pharmaceuticals over five years for Queensland women with breast cancer. We used a linked administrative dataset, CancerCostMod, limited to Queensland female breast cancer diagnoses between July 2011 and June 2013 aged 18 years or over who survived for 5 years (n = 5383). Each record was linked to Queensland Health Admitted Patient Data Collection, Emergency Department Information Systems, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between July 2011 and June 2018. Total costs for different healthcare funders as a result of breast cancer diagnoses were reported, with high costs and service use identified in the first six months following a breast cancer diagnosis. After the first six months post-diagnosis, the financial burdens incurred by different healthcare funders for breast cancer diagnoses in Queensland remain steady over a long period. Recommendations for reducing long term costs are discussed. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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13 pages, 2196 KiB

Open AccessArticle

Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up

by Louisa G. Gordon, Elizabeth G. Eakin, Rosalind R. Spence, Christopher Pyke, John Bashford, Christobel Saunders and Sandra C. Hayes

Int. J. Environ. Res. Public Health 2020, 17(22), 8608; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228608 - 19 Nov 2020

Cited by 5 | Viewed by 2793

Abstract

Studies show conflicting results on whether exercise interventions to improve outcomes for women with breast cancer are cost-effective. We modelled the long-term cost-effectiveness of the Exercise for Health intervention compared with usual care. A lifetime Markov cohort model for women with early breast cancer was constructed taking a societal perspective. Data were obtained from trial, epidemiological, quality of life, and healthcare cost reports. Outcomes were calculated from 5000 Monte Carlo simulations, and one-way and probabilistic sensitivity analyses. Over the cohort’s remaining life, the incremental cost for the exercise versus usual care groups were $7409 and quality-adjusted life years (QALYs) gained were 0.35 resulting in an incremental cost per QALY ratio of AU$21,247 (95% Uncertainty Interval (UI): Dominant, AU$31,398). The likelihood that the exercise intervention was cost-effective at acceptable levels was 93.0%. The incremental cost per life year gained was AU$8894 (95% UI Dominant, AU$11,769) with a 99.4% probability of being cost effective. Findings were most sensitive to the probability of recurrence in the exercise and usual care groups, followed by the costs of out-of-pocket expenses and the model starting age. This exercise intervention for women after early-stage breast cancer is cost-effective and would be a sound investment of healthcare resources. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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20 pages, 748 KiB

Open AccessArticle

Real-World Setting Cost-Effectiveness Analysis Comparing Three Therapeutic Schemes of One-Year Adjuvant Trastuzumab in HER2-Positive Early Breast Cancer from the Cyprus NHS Payer Perspective

by Savvas S. Ioannou, Yiola Marcou, Eleni Kakouri and Michael A. Talias

Int. J. Environ. Res. Public Health 2020, 17(12), 4339; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124339 - 17 Jun 2020

Cited by 3 | Viewed by 2423

Abstract

Introduction: This study is one of the first real-world cost-effectiveness analyses of one-year adjuvant trastuzumab used in HER2-positive early female breast cancer in comparison to chemotherapy alone. It is just the second one in Europe, the first one in Cyprus, and the fourth one worldwide ever carried out using real-world data. Methods: Using a Markov model (four health states), a cost-effectiveness analysis was carried out both over 20 years and for a lifetime horizon. The sampling method used in this study was the randomized sampling of 900 women. Results: The findings for the 20-year horizon showed that all trastuzumab arms were more cost-effective, with a willingness-to-pay threshold of only €60,000 per quality-adjusted life year (QALY) [incremental cost-effectiveness ratios (ICER): €40,436.10/QALY]. For the lifetime horizon, with thresholds of €20,000, €40,000, and €60,000/QALY, all trastuzumab arms were found to be more cost-effective (ICER: €17,753.85/QALY). Moreover, for the 20-year and the lifetime horizons, with thresholds of €20,000/QALY, €40,000/QALY, and €60,000/QALY, the most cost-effective of the three subgroups (anthracyclines and then trastuzumab, no anthracyclines and then trastuzumab, and anthracyclines, taxanes, and trastuzumab) was that of anthracyclines and then trastuzumab (ICER: €18,301.55/QALY and €8954.97/QALY, respectively). Conclusions: The study revealed that adjuvant trastuzumab for one year in female HER2-positive early breast cancer can be considered cost-effective. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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Review

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34 pages, 938 KiB

Open AccessReview

Economic Evaluation of Long-Term Survivorship Care for Cancer Patients in OECD Countries: A Systematic Review for Decision-Makers

by David Brain and Amarzaya Jadambaa

Int. J. Environ. Res. Public Health 2021, 18(21), 11558; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111558 - 03 Nov 2021

Cited by 2 | Viewed by 1854

Abstract

Long-term cancer survivorship care is a crucial component of an efficient healthcare system. For numerous reasons, there has been an increase in the number of cancer survivors; therefore, healthcare decision-makers are tasked with balancing a finite budget with a strong demand for services. Decision-makers require clear and pragmatic interpretation of results to inform resource allocation decisions. For these reasons, the impact and importance of economic evidence are increasing. The aim of the current study was to conduct a systematic review of economic evaluations of long-term cancer survivorship care in Organization for Economic Co-operation and Development (OECD) member countries and to assess the usefulness of economic evidence for decision-makers. A systematic review of electronic databases, including MEDLINE, PubMed, PsycINFO and others, was conducted. The reporting quality of the included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Each included study’s usefulness for decision-makers was assessed using an adapted version of a previously published approach. Overall, 3597 studies were screened, and of the 235 studies assessed for eligibility, 34 satisfied the pre-determined inclusion criteria. We found that the majority of the included studies had limited value for informing healthcare decision-making and conclude that this represents an ongoing issue in the field. We recommend that authors explicitly include a policy statement as part of their presentation of results. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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Other

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16 pages, 1112 KiB

Open AccessProtocol

Lifetime Costs of Surviving Cancer—A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study

by Katharina M. D. Merollini, Louisa G. Gordon, Joanne F. Aitken and Michael G. Kimlin

Int. J. Environ. Res. Public Health 2020, 17(8), 2831; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082831 - 20 Apr 2020

Cited by 6 | Viewed by 2492

Abstract

Australia-wide, there are currently more than one million cancer survivors. There are over 32 million world-wide. A trend of increasing cancer incidence, medical innovations and extended survival places growing pressure on healthcare systems to manage the ongoing and late effects of cancer treatment. There are no published studies of the long-term health service use and cost of cancer survivorship on a population basis in Australia. All residents of the state of Queensland, Australia, diagnosed with a first primary malignancy from 1997–2015 formed the cohort of interest. State and national healthcare databases are linked with cancer registry records to capture all health service utilization and healthcare costs for 20 years (or death, if this occurs first), starting from the date of cancer diagnosis, including hospital admissions, emergency presentations, healthcare costing data, Medicare services and pharmaceuticals. Data analyses include regression and economic modeling. We capture the whole journey of health service contact and estimate long-term costs of all cancer patients diagnosed and treated in Queensland by linking routinely collected state and national healthcare data. Our results may improve the understanding of lifetime health effects faced by cancer survivors and estimate related healthcare costs. Research outcomes may inform policy and facilitate future planning for the allocation of healthcare resources according to the burden of disease. Full article

(This article belongs to the Special Issue The Economic Impact and Cost-Effectiveness of Long-Term Cancer Survivorship (>5 Years))

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