The Cost-Effectiveness of Salpingectomies for Family Planning in the Prevention of Ovarian Cancer

2018 ◽  
Vol 40 (3) ◽  
pp. 317-327 ◽  
Author(s):  
R.W. Melissa Tai ◽  
Stephanie K.Y. Choi ◽  
Peter C. Coyte
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Family Planning ◽  
The Cost

scholarly journals The cost-effectiveness of screening for ovarian cancer: results from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

2017 ◽  
Vol 117 (5) ◽  
pp. 619-627 ◽  
Author(s):  
Usha Menon ◽  
Alistair J McGuire ◽  
Maria Raikou ◽  
Andy Ryan ◽  
Susan K Davies ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Ovarian Cancer Screening ◽  
Collaborative Trial ◽  
The Uk ◽  
The Cost

Is FDA-Approved Bevacizumab Cost-Effective When Included in the Treatment of Platinum-Resistant Recurrent Ovarian Cancer?

2016 ◽  
Vol 12 (7) ◽  
pp. e775-e783 ◽  
Author(s):  
Nicole P. Chappell ◽  
Caela R. Miller ◽  
Aaron D. Fielden ◽  
Jason C. Barnett
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Willingness To Pay ◽  
Progression Free Survival ◽  
Recurrent Ovarian Cancer ◽  
Phase Iii ◽  
Value Assessment ◽  
Free Survival ◽  
Platinum Resistant ◽  
The Cost

Purpose: Although the Food and Drug Administration has approved incorporation of bevacizumab (BEV) into the treatment of platinum-resistant ovarian cancer (PROC), cost-value measures are an essential consideration, as evidenced by the recent ASCO Value Framework initiative. We assessed the cost-effectiveness and reviewed the net health benefit (NHB) of this expensive treatment. Methods: A cost-effectiveness decision model was constructed using results from a phase III trial comparing BEV plus cytotoxic chemotherapy with chemotherapy alone in patients with PROC. The Avastin Use in Platinum-Resistant Epithelial Ovarian Cancer (AURELIA) trial demonstrated improvement in progression-free survival and quality of life in patients receiving BEV. Costs, paracentesis rates, and adverse events were incorporated, including subgroup analysis of different partner chemotherapy agents. Results: Inclusion of BEV in the treatment of platinum-resistant recurrent ovarian cancer meets the common willingness-to-pay incremental cost-effectiveness ratio (ICER) threshold of $100,000 per progression-free life-year saved (LYS) for 15-mg/kg dosing and approaches this threshold for 10-mg/kg dosing, with an ICER of $160,000. In sensitivity analysis, reducing the cost of BEV by 13% (from $9,338 to $8,100 per cycle) allows 10-mg/kg dosing to reach a $100,000 ICER. Exploratory analysis of different BEV chemotherapy partners showed an ICER of $76,000 per progression-free LYS (6.5-month progression-free survival improvement) and $54,000 per LYS (9.1-month overall survival improvement) for the addition of BEV to paclitaxel once per week. Using the ASCO framework for value assessment, the NHB score for BEV plus paclitaxel once per week is 48. Conclusion: Using a willingness-to-pay threshold of $100,000 ICER, the addition of BEV to chemotherapy either demonstrates or approaches cost-effectiveness and NHB when added to the treatment of patients with PROC.

Cost-effectiveness studies in ovarian cancer

2003 ◽  
Vol 13 (Suppl 2) ◽  
pp. 212-219
Author(s):  
T. D. Szucs ◽  
P. Wyss ◽  
K. J. Dedes
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Clinical Decision ◽  
Cost Utility ◽  
Chemotherapy Drugs ◽  
Pain And Suffering ◽  
Acquisition Costs ◽  
The Cost ◽  
Effectiveness Studies ◽  
The Impact

Ovarian cancer is the fifth leading cause of cancer-related deaths. The costs associated with this cancer impact both on the affected individual and on the health system. Screening is currently unproven as a strategy for improving outcomes for women with ovarian cancer. Randomized controlled trials, however, are underway, estimating any impact of screening with ultrasound and CA125 on ovarian cancer mortality. Paclitaxel and carboplatin combination, the standard first-line chemotherapy regimen for ovarian cancer, has not been compared with cisplatin and cyclophosphamide regarding the cost-effectiveness and cost-utility, but for paclitaxel and cisplatin, numerous studies have addressed these issues. The estimated incremental costs resulting from these studies fall well within the generally accepted range for new therapies. Although acquisition costs of new chemotherapy drugs exceed those of older drugs, the impact of costly drugs on total costs may be cost saving due to less costs related to supportive and palliative care. The most important costs for the patient, the pain and suffering associated with ovarian cancer and its treatment, are hard to quantify. Nevertheless, patients' quality of life must be considered when making a clinical decision to treat this disease. A review of available cost-effectiveness studies is presented and discussed.

scholarly journals Cost Effectiveness of Intraperitoneal Compared With Intravenous Chemotherapy for Women With Optimally Resected Stage III Ovarian Cancer: A Gynecologic Oncology Group Study

2008 ◽  
Vol 26 (25) ◽  
pp. 4144-4150 ◽  
Author(s):  
Laura J. Havrilesky ◽  
Angeles Alvarez Secord ◽  
Kathleen M. Darcy ◽  
Deborah K. Armstrong ◽  
Shalini Kulasingam
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Time Horizon ◽  
Gynecologic Oncology ◽  
Cost Effective ◽  
Stage Iii ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Resected Stage ◽  
The Cost

Purpose To determine the cost effectiveness of intraperitoneal versus intravenous regimens for adjuvant treatment of optimally resected stage III ovarian cancer. Patients and Methods A decision model was developed to compare the cost effectiveness at 7-, 11.5-, and 35-year horizons of intravenous carboplatin and paclitaxel (IV-CARBO/PAC), intravenous cisplatin and paclitaxel (IV-CIS/PAC), or intravenous paclitaxel followed by intraperitoneal cisplatin and paclitaxel (IP-CIS/PAC). Survival data were from women participating in representative Gynecologic Oncology Group (GOG) protocols. Medicare reimbursement rates and the Agency for Healthcare Research and Quality Database were used to estimate costs for treatment regimens and grade 3 to 4 adverse effects, respectively. Results Median predicted survival was 66, 57, 51, and 48 months for IP-CIS/PAC, IV-CARBO/PAC, IV-CIS/PAC (GOG 172), or IV-CIS/PAC (GOG 158), respectively. Across a range of analyses, IV-CIS/PAC was more costly and had lower life expectancy than IV-CARBO/PAC. Compared with IV-CARBO/PAC, IP-CIS/PAC had an incremental cost-effectiveness ratio (ICER) of $180,022 per quality-adjusted life year (QALY) saved at a 7-year time horizon, $71,835/QALY at 11.5 years, and $32,053/QALY over a lifetime. Extending the survival advantage of IP-CIS/PAC over 11.5 years and a lifetime results in ICERs of $26,249 and $23,973, respectively. Assuming IP-CIS/PAC and IV-CIS/PAC were equally effective when administered on an outpatient basis, the ICER of IP-CIS/PAC compared with IV-CARBO/PAC was $26,311. Conclusion Inpatient IP-CIS/PAC, while not cost effective compared with IV-CARBO/PAC at 7 years, becomes cost effective if a longer time horizon is modeled and/or a survival benefit can be assumed to persist longer than currently available data. Outpatient IP-CIS/PAC may also be cost effective compared with IV-CARBO/PAC if proven as effective as inpatient IP-CIS/PAC.

scholarly journals The cost-effectiveness of opportunistic salpingectomy versus standard tubal ligation at the time of cesarean delivery for ovarian cancer risk reduction

2019 ◽  
Vol 152 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Akila Subramaniam ◽  
Brett D. Einerson ◽  
Christina T. Blanchard ◽  
Britt K. Erickson ◽  
Jeff Szychowski ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Cancer Risk ◽  
Risk Reduction ◽  
Cesarean Delivery ◽  
Tubal Ligation ◽  
Ovarian Cancer Risk ◽  
The Cost ◽  
Opportunistic Salpingectomy ◽  
Cancer Risk Reduction

scholarly journals Cost-effectiveness of a mobile phone-based support intervention to increase uptake of post-abortion family planning in Cambodia (Preprint)

2019 ◽  
Author(s):  
Jeremy Hill ◽  
Jourdan McGinn ◽  
John Cairns ◽  
Caroline Free ◽  
Chris Smith
Keyword(s):  
Cost Effectiveness ◽  
Family Planning ◽  
Incremental Cost ◽  
Mobile Phone ◽  
Mobile Technology ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Disability Adjusted Life ◽  
Post Abortion ◽  
The Cost

BACKGROUND Despite progress over the last decade, there is a continuing unmet need for contraception in Cambodia. Interventions delivered by mobile phone could help increase uptake and continuation of contraception, particularly amongst hard-to-reach populations, by providing interactive, personalised support inexpensively wherever the person is located and whenever needed. OBJECTIVE The objective of this study was to evaluate the cost-effectiveness of mobile phone-based support added to standard post-abortion family planning care in Cambodia, based on results of the MObile Technology for Improved Family Planning (MOTIF) trial. METHODS A model was created to estimate the costs and effects of the intervention versus standard care. We adopted a societal perspective when estimating costs, including direct and indirect costs for users. The incremental cost-effectiveness ratio was calculated for the base case, as well as a deterministic and probabilistic sensitivity analysis, which we compared against a range of likely cost-effectiveness thresholds. RESULTS The incremental cost of mobile phone-based support was estimated to be an additional $8,160.49 per 1000 clients, leading to an estimated 518 couple-years of protection gained per 1,000 clients and 99 disability adjusted life years averted. The Incremental Cost-Effectiveness Ratio (ICER) was $15.75 per additional Couple Year of Protection (CYP) and $82.57 per Disability Adjusted Life Year (DALY) averted. The model was most sensitive to personnel and mobile service costs. Assuming a range of cost-effectiveness thresholds of $58 to $176 for Cambodia, the probability of the intervention being cost-effective ranged from 11% to 95%. CONCLUSIONS This study demonstrates that the cost-effectiveness of the intervention delivered by mobile phone studied in the MOTIF trial lies within the estimated range of cost-effectiveness thresholds for Cambodia. When assessing value in interventions to improve the uptake and adherence to family planning services, the use of interactive mobile phone messaging and counselling for women who have had an abortion should be considered as an option to policy makers. CLINICALTRIAL This study is a cost-effectiveness analysis of the intervention evaluated in the Mobile Technology for Improved Family Planning (MOTIF) trial: ClinicalTrials.gov NCT01823861.

scholarly journals Data on Utility in Cost–Utility Analyses of Genetic Screen-and-Treat Strategies for Breast and Ovarian Cancer

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4879
Author(s):  
Julia Simões Corrêa Simões Corrêa Galendi ◽  
Vera Vennedey ◽  
Hannah Kentenich ◽  
Stephanie Stock ◽  
Dirk Müller
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Heterogeneous Data ◽  
Cost Utility ◽  
Genetic Screen ◽  
Health States ◽  
Utility Values ◽  
The Cost ◽  
The Impact ◽  
Risk Reducing

Genetic screen-and-treat strategies for the risk-reduction of breast cancer (BC) and ovarian cancer (OC) are often evaluated by cost–utility analyses (CUAs). This analysis compares data on health preferences (i.e., utility values) in CUAs of targeted genetic testing for BC and OC. Based on utilities applied in fourteen CUAs, data on utility including related assumptions were extracted for the health states: (i) genetic test, (ii) risk-reducing surgeries, (iii) BC/OC and (iv) post cancer. In addition, information about the sources of utility and the impact on the cost-effectiveness was extracted. Utility for CUAs relied on heterogeneous data and assumptions for all health states. The utility values ranged from 0.68 to 0.97 for risk-reducing surgeries, 0.6 to 0.85 for BC and 0.5 to 0.82 for OC. In two out of nine studies, considering the impact of the test result strongly affected the cost–effectiveness ratio. While in general utilities seem not to affect the cost–utility ratio, in future modeling studies the impact of a positive/negative test on utility should be considered mandatory. Women’s health preferences, which may have changed as a result of improved oncologic care and genetic counselling, should be re-evaluated.

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