Enhanced recovery after surgery (ERAS) for ovarian cancer: Analyzing the cost effectiveness of a recovery program in primary cytoreductve surgery

2017 ◽  
Vol 145 ◽  
pp. 6-7
Author(s):  
R. Neff ◽  
J.D. Wright ◽  
D.E. Cohn ◽  
L.J. Havrilesky
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
The Cost ◽  
Recovery Program

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.

Enhanced recovery after surgery in advanced ovarian cancer: a prospective randomized trial

2019 ◽  
Author(s):  
JL Sánchez-Iglesias ◽  
M Carbonell Socias ◽  
A Pérez Benavente ◽  
NR Gómez-Hidalgo ◽  
S Manrique Muñoz ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Randomized Trial ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Advanced Ovarian Cancer ◽  
Prospective Randomized Trial

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 Regional Anaesthesia in Enhanced Recovery After Surgery Pathways – A Quintessential Component

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Abhijit S. Nair ◽  
Sandeep Diwan
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Care Pathway ◽  
Early Discharge ◽  
Major Surgery ◽  
Emergency Laparotomy ◽  
Early Recovery ◽  
Recovery Pathways ◽  
Perioperative Care Pathway ◽  
The Cost

Enhanced recovery after surgery (ERAS) is a multimodal, perioperative care pathway designed to achieve early recovery for patients undergoing major surgery. [1] Initially described by Henry Kehlet in 1995 for colonic surgeries, the enhanced recovery pathways have now evolved and are now validated for more than 30 different types of surgery which include but are not limited to emergency laparotomy, neonatal surgeries, and lower segment cesarean sections. [2] Not only is the patient benefited from this by having an enhanced recovery and early discharge from the hospital, the cost of treatment is reduced and also leads to more turnover of patients thereby reducing the waiting list of patients scheduled for various surgeries. [3]

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