Cost-effectiveness studies in ovarian cancer

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.

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A Critical Appraisal and Recommendations for Cost-Effectiveness Studies of Poly(ADP-Ribose) Polymerase Inhibitors in Advanced Ovarian Cancer

PharmacoEconomics ◽

10.1007/s40273-020-00949-9 ◽

2020 ◽

Vol 38 (11) ◽

pp. 1201-1218 ◽

Cited By ~ 1

Author(s):

Wei Gao ◽

Dominic Muston ◽

Matthew Monberg ◽

Kimmie McLaurin ◽

Robert Hettle ◽

...

Keyword(s):

Ovarian Cancer ◽

Cost Effectiveness ◽

Critical Appraisal ◽

Advanced Ovarian Cancer ◽

Polymerase Inhibitors ◽

Effectiveness Studies

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A Review of Cost-Effectiveness Studies in Ovarian Cancer

Cancer Control ◽

10.1177/107327481101800109 ◽

2011 ◽

Vol 18 (1) ◽

pp. 59-64 ◽

Cited By ~ 19

Author(s):

Gregory P. Sfakianos ◽

Laura J. Havrilesky

Keyword(s):

Ovarian Cancer ◽

Cost Effectiveness ◽

Effectiveness Studies

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A Systematic Review on Cost-effectiveness Studies Evaluating Ovarian Cancer Early Detection and Prevention Strategies

Cancer Prevention Research ◽

10.1158/1940-6207.capr-19-0506 ◽

2020 ◽

Vol 13 (5) ◽

pp. 429-442

Author(s):

Gaby Sroczynski ◽

Artemisa Gogollari ◽

Felicitas Kuehne ◽

Lára R. Hallsson ◽

Martin Widschwendter ◽

...

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Cost Effectiveness ◽

Early Detection ◽

Prevention Strategies ◽

Cancer Early Detection ◽

Effectiveness Studies ◽

Early Detection And Prevention

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PP148 Liquid Biopsy For The Detection Of Ovarian Or Endometrial Cancer In Samples Taken From The Pap Smear: PapSEEK

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462321001215 ◽

2021 ◽

Vol 37 (S1) ◽

pp. 22-23

Author(s):

Vanesa Ramos García ◽

Lilisbeth Perestelo-Pérez ◽

Amado Rivero-Santana ◽

Andrea Duare-Díaz ◽

Yolanda Álvarez-Pérez ◽

...

Keyword(s):

Ovarian Cancer ◽

Endometrial Cancer ◽

Cost Effectiveness ◽

Incremental Cost ◽

Pap Smear ◽

Cochrane Library ◽

Invasive Technique ◽

Screening Methods ◽

Diagnostic Validity ◽

Effectiveness Studies

IntroductionThe PapSEEK test is an emerging minimally invasive technique in which samples are collected from the endocervical or intrauterine cavity with the Papanicolaou (Pap) brush or the Tao brush to detect somatic mutations or aneuploidies indicating the presence of endometrial or ovarian cancer.MethodsWe systematically searched for articles published up to October 2020 in the following electronic databases: Medline, Embase, the Cochrane Library, and the Centre for Reviews and Dissemination. We included experimental studies, observational primary studies, and cost-effectiveness studies evaluating the safety, effectiveness, and cost effectiveness of the PapSEEK test for the early detection of ovarian or endometrial cancer. Relevant outcomes included sensitivity, specificity, the coefficient of variation, re-test rates, the incremental cost-effectiveness ratio, the incremental cost-utility ratio, and the cost of each alternative.ResultsA single relevant retrospective study was identified. In this study, samples from women with endometrial cancer (n = 656) and ovarian cancer (n = 254) were collected with the Pap brush and Tao brush and compared with samples from healthy women (n = 1,002). The diagnostic validity for somatic mutation or aneuploidies obtained with a Pap brush had a sensitivity of 81% for endometrial cancer and 33% for ovarian cancer, and a specificity of 99% for both conditions. When samples were collected from the intrauterine cavity with a Tao brush, the sensitivity increased to 93% for endometrial cancer and to 45% for ovarian cancer. The sensitivity of the PapSEEK test increased only for ovarian cancer when plasma samples to detect circulating tumor DNA were collected in addition to Pap smear samples. This strategy provided a diagnostic validity of 43%, which was higher in late-stage ovarian cancer (56% versus 35%), and a specificity of 100%.ConclusionsProspectively designed studies are required to assess the safety and effectiveness of the PapSEEK test in screening settings, as well as studies comparing the technology with conventional screening methods. No cost-effectiveness studies have been conducted for the PapSEEK test.

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A Systematic Review of Cost-Effectiveness Studies of Interventions With a Personalized Nutrition Component in Adults

Value in Health ◽

10.1016/j.jval.2020.12.006 ◽

2021 ◽

Vol 24 (3) ◽

pp. 325-335 ◽

Cited By ~ 1

Author(s):

Milanne M.J. Galekop ◽

Carin A. Uyl-de Groot ◽

W. Ken Redekop

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Personalized Nutrition ◽

Nutrition Component ◽

Effectiveness Studies

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A Call for a Reform of the Influenza Immunization Program in Mexico: Epidemiologic and Economic Evidence for Decision Making

Vaccines ◽

10.3390/vaccines9030286 ◽

2021 ◽

Vol 9 (3) ◽

pp. 286

Author(s):

Roberto Tapia-Conyer ◽

Miguel Betancourt-Cravioto ◽

Alejandra Montoya ◽

Jorge Abelardo Falcón-Lezama ◽

Myrna María Alfaro-Cortes ◽

...

Keyword(s):

Cost Effectiveness ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Decision Analytic Model ◽

Limited Information ◽

Vaccination Policy ◽

Cross Sectional ◽

Influenza Case ◽

One Year ◽

Effectiveness Studies

Limited information is available to determine the effectiveness of Mexico’s national influenza vaccination guidelines and inform policy updates. We aim to propose reforms to current influenza vaccination policies based on our analysis of cost-effectiveness studies. This cross-sectional epidemiological study used influenza case, death, discharge and hospitalization data from several influenza seasons and applied a one-year decision-analytic model to assess cost-effectiveness. The primary health outcome was influenza cases avoided; secondary health outcomes were influenza-related events associated with case reduction. By increasing vaccination coverage to 75% in the population aged 12–49 years with risk factors (diabetes, high blood pressure, morbid obesity, chronic renal failure, asthma, pregnancy), and expanding universal vaccination coverage to school-aged children (5–11 years) and adults aged 50–59 years, 7142–671,461 influenza cases; 1–15 deaths; 7615–262,812 healthcare visits; 2886–154,143 emergency room admissions and 2891–97,637 hospitalizations could be prevented (ranges correspond to separate age and risk factor groups), with a net annual savings of 3.90 to 111.99 million USD. Such changes to the current vaccination policy could potentially result in significant economic and health benefits. These data could be used to inform the revision of a vaccination policy in Mexico with substantial social value.

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Cost-effectiveness of maintenance hormonal therapy in patients with advanced low grade serous ovarian cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.09.051 ◽

2021 ◽

Vol 160 (1) ◽

pp. 206-213

Author(s):

Andra Nica ◽

Ji Young Jennifer Lee ◽

Nicole Look Hong ◽

Taymaa May

Keyword(s):

Ovarian Cancer ◽

Cost Effectiveness ◽

Hormonal Therapy ◽

Low Grade ◽

Serous Ovarian Cancer

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The Cost-Effectiveness of Multigene Panel Testing for Hereditary Breast and Ovarian Cancer in Norway

MDM Policy & Practice ◽

10.1177/2381468318821103 ◽

2019 ◽

Vol 4 (1) ◽

pp. 238146831882110 ◽

Cited By ~ 4

Author(s):

Lars Asphaug ◽

Hans Olav Melberg

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Cost Effectiveness ◽

Gene Panel ◽

Breast Cancer Patients ◽

Brca Testing ◽

Early Onset Breast Cancer ◽

Breast And Ovarian Cancer ◽

Quality Adjusted Life ◽

Multigene Panel

Background. Expansion of routine genetic testing for hereditary breast and ovarian cancer from conventional BRCA testing to a multigene test could improve diagnostic yield and increase the opportunity for cancer prevention in both identified carriers and their relatives. We use an economic decision model to assess whether the current knowledge on non- BRCA mutation prevalence, cancer risk, and patient preferences justifies switching to a multigene panel for testing of early-onset breast cancer patients. Methods. We evaluated routine testing by BRCA testing, a 7-gene panel, and a 14-gene panel using individual-level simulations of annual health state transitions over a lifetime perspective. Breast and ovarian cancer incidence is reduced and posttreatment survival is improved when high-risk mutations are detected and risk-reducing treatment offered. Most model inputs were synthesized from published literature. Intermediate health outcomes included breast and ovarian cancer incidence rates, along with organ-specific cancer mortality. Cost-effectiveness outcomes were health sector costs and quality-adjusted life years. Results. Intermediate health outcomes improved by testing with multigene panels. At a cost-effectiveness threshold of $77,000, a 7-gene panel test with five non- BRCA genes was the optimal strategy with an incremental cost-effectiveness ratio of $53,310 per quality-adjusted life year compared to BRCA-only testing. Limitations. Unable to stratify carriers to specific mutations within genes, we can only make predictions on the gene level, with combined risk estimates for known variants. As mutation prevalence is the absolute upper bound of returns to more expansive testing, the rarity of modelled mutations makes analysis outcomes sensitive to model implementation. Conclusions. A 7-gene panel to diagnose hereditary breast and ovarian cancer in early-onset breast cancer patients can be a cost-effective alternative to current BRCA-only testing in Norway.

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