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When is Cancer Care Cost-Effective? A Systematic Overview of Cost–Utility Analyses in Oncology

机译:癌症护理何时才具有成本效益?肿瘤学成本-效用分析的系统概述

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摘要

New cancer treatments pose a substantial financial burden on health-care systems, insurers, patients, and society. Cost–utility analyses (CUAs) of cancer-related interventions have received increased attention in the medical literature and are being used to inform reimbursement decisions in many health-care systems. We identified and reviewed 242 cancer-related CUAs published through 2007 and included in the Tufts Medical Center Cost-Effectiveness Analysis Registry (). Leading cancer types studied were breast (36% of studies), colorectal (12%), and hematologic cancers (10%). Studies have examined interventions for tertiary prevention (73% of studies), secondary prevention (19%), and primary prevention (8%). We present league tables by disease categories that consist of a description of the intervention, its comparator, the target population, and the incremental cost-effectiveness ratio. The median reported incremental cost-effectiveness ratios (in 2008 US $) were $27 000 for breast cancer, $22 000 for colorectal cancer, $34 500 for prostate cancer, $32 000 for lung cancer, and $48 000 for hematologic cancers. The results highlight the many opportunities for efficient investment in cancer care across different cancer types and interventions and the many investments that are inefficient. Because we found only modest improvement in the quality of studies, we suggest that journals provide specific guidance for reporting CUA and assure that authors adhere to guidelines for conducting and reporting economic evaluations.
机译:新的癌症治疗给医疗保健系统,保险公司,患者和社会带来了沉重的财务负担。癌症相关干预措施的成本-效用分析(CUA)在医学文献中受到越来越多的关注,并被用于许多医疗保健系统中的报销决策。我们确定并审查了到2007年发布的242例与癌症相关的CUA,并纳入了塔夫茨医学中心成本效益分析注册表()。研究的主要癌症类型是乳腺癌(占研究的36%),结直肠癌(占12%)和血液学癌症(占10%)。研究检查了三级预防(占研究的73%),二级预防(占19%)和一级预防(占8%)的干预措施。我们按疾病类别列出了联赛表,包括对干预措施的描述,其比较者,目标人群以及成本效益比的增加。报告的成本效益比中位数(2008年,美元)分别为:乳腺癌$ 27 000,结直肠癌$ 22 000,前列腺癌$ 34 500,肺癌$ 32 000和血液系统癌$ 48 000。结果突出显示了在不同癌症类型和干预措施之间有效投资于癌症护理的众多机会,以及许多效率低下的投资。因为我们发现研究质量仅获得了适度的提高,所以我们建议期刊为报告CUA提供具体指导,并确保作者遵守进行和报告经济评估的指导原则。

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