scholarly journals OP013/#417 Cost-effectiveness of dostarlimab in advanced recurrent deficient mismatch repair endometrial cancer patients

2021 ◽  
Author(s):  
S Dioun ◽  
L Chen ◽  
A Gockley ◽  
A Melamed ◽  
C St Clair ◽  
...  
2013 ◽  
Vol 129 (1) ◽  
pp. 188-192 ◽  
Author(s):  
Keith Y. Terada ◽  
Michael Black ◽  
Laura H. Terada ◽  
James Davis ◽  
David M. Shimizu

2020 ◽  
Vol 9 (6) ◽  
pp. 1664 ◽  
Author(s):  
Tristan M. Snowsill ◽  
Neil A. J. Ryan ◽  
Emma J. Crosbie

Lynch syndrome (LS) is a hereditary cancer syndrome responsible for 3% of all endometrial cancer and 5% in those aged under 70 years. It is unclear whether universal testing for LS in endometrial cancer patients would be cost-effective. The Manchester approach to identifying LS in endometrial cancer patients uses immunohistochemistry (IHC) to detect mismatch repair (MMR) deficiency, incorporates testing for MLH1 promoter hypermethylation, and incorporates genetic testing for pathogenic MMR variants. We aimed to assess the cost-effectiveness of the Manchester approach on the basis of primary research data from clinical practice in Manchester. The Proportion of Endometrial Tumours Associated with Lynch Syndrome (PETALS) study informed estimates of diagnostic performances for a number of different strategies. A recent microcosting study was adapted and was used to estimate diagnostic costs. A Markov model was used to predict long-term costs and health outcomes (measured in quality-adjusted life years, QALYs) for individuals and their relatives. Bootstrapping and probabilistic sensitivity analysis were used to estimate the uncertainty in cost-effectiveness. The Manchester approach dominated other reflex testing strategies when considering diagnostic costs and Lynch syndrome cases identified. When considering long-term costs and QALYs the Manchester approach was the optimal strategy, costing £5459 per QALY gained (compared to thresholds of £20,000 to £30,000 per QALY commonly used in the National Health Service (NHS)). Cost-effectiveness is not an argument for restricting testing to younger patients or those with a strong family history. Universal testing for Lynch syndrome in endometrial cancer patients is expected to be cost-effective in the U.K. (NHS), and the Manchester approach is expected to be the optimal testing strategy.


2016 ◽  
Vol 143 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Anne Goverde ◽  
Manon CW Spaander ◽  
Helena C van Doorn ◽  
Hendrikus J Dubbink ◽  
Ans MW van den Ouweland ◽  
...  

2004 ◽  
Vol 14 (5) ◽  
pp. 931-937 ◽  
Author(s):  
W. A. A. Tjalma ◽  
P. A. Van Dam ◽  
A. P. Makar ◽  
D. J. Cruickshank

The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2028.78 and between 207.48 and 2353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called ‘standard medical practice of follow-up.’ It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.


2019 ◽  
Vol 45 (10) ◽  
pp. 1854-1861 ◽  
Author(s):  
Ioannis Gkekas ◽  
Jan Novotny ◽  
Pavel Fabian ◽  
Radim Nemecek ◽  
Richard Palmqvist ◽  
...  

2021 ◽  
Vol 160 (1) ◽  
pp. 161-168
Author(s):  
Heather Hampel ◽  
Rachel Pearlman ◽  
Albert de la Chapelle ◽  
Colin C. Pritchard ◽  
Weiqiang Zhao ◽  
...  

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