scholarly journals Analisis Cost-Effectiveness Seftazidim Generik pada Pasien Kanker Payudara di Rumah Sakit Kanker “Dharmais” Jakarta, 2012

2016 ◽  
Vol 10 (3) ◽  
pp. 113
Author(s):  
NADIA FARHANAH SYAFHAN ◽  
AGUSDINI BANUN SAPTANINGSIH ◽  
MUTIARA JEANY RAHAYU PERTIWI
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Direct Medical Cost ◽  
Cancer Patients ◽  
Medical Cost ◽  
Late Stage ◽  
Early Stage ◽  
Cost Effective ◽  
Breast Cancer Patients ◽  
Total Direct Medical Cost

ABSTRACTAdministration of ceftazidime shortened duration of neutropenia and hospitalization days in breast cancer patients who had infection after myelosupressive chemotherapy. Cost-effectiveness analysis (CEA) as one of pharmacoeconomic methods was important to determine treatment attaining effect for lower cost. The aim of this study was to comparethe total direct medical cost and effectiveness, which was measured from length-of-stay (LOS), of generic ceftazidime A and B usage, and to decide which ceftazidime that was more cost-effective in early-stage and late-stage breast cancer patients at National Cancer Center Dharmais Hospital Jakarta year 2012. The study design was non-experimental withcomparative study retrospectively on secondary data from medical records and administrative data in 2012. Samples were taken by using total sampling method. The number of samples were 9 patients, which included 7 patients with generic ceftazidime A and 2 patients with generic ceftazidime B. The total direct medical cost of generic ceftazidime A in early-stage and late-stage breast cancer patients, respectively Rp 15.930.407,45 and Rp 15.962.519,25, were higher than generic B, respectively Rp 6.716.225,21 and Rp 7.147.956,92. Median LOS of generic A ceftazidime in early-stage and late-stage breast cancer patients, respectively 7 days and 10 days, were longer than generic B, respectively 3 days and 4 days. According to CEA result, generic ceftazidime B was more cost-effective than generic A.ABSTRAKPemberian seftazidim dapat mempersingkat durasi neutropenia dan lama hari rawat inap pada pasien kanker payudara yang mengalami infeksi setelah kemoterapi mielosupresif. Analisis cost-effectiveness merupakan salah satu metode farmakoekonomi yang penting untuk menentukan obat efektif dengan biaya yang lebih rendah. Penelitian dilakukan untuk membandingkan total biaya medis langsung dan efektivitas yang dilihat dari lama hari rawat penggunaan seftazidim generik A dan B, serta menentukan seftazidim yang lebih cost-effective pada pasien kanker payudara stadium awal dan lanjut di Rumah Sakit Kanker “Dharmais” Jakarta, 2012. Desain penelitian yang digunakan adalah studi komparatif secara retrospektif terhadap data rekam medis dan administrasi tahun 2012. Pengambilan sampel dilakukan secara total sampling. Jumlah pasien yang dilibatkan dalam analisis 9 pasien, yaitu 7 pasien menggunakan seftazidim generik A dan 2 pasien menggunakan seftazidim generik B. Median total biaya medis langsung kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut sebesar Rp 15.930.407,45 dan Rp 15.962.519,25 lebih tinggi dibanding generik B, berturut-turut sebesar Rp 6.716.225,21 dan Rp 7.147.956,92. Median lama hari rawat kelompok generik A pada pasien kanker stadium awal maupun lanjut berturut-turut 7 hari dan 10 hari, lebih panjang dibanding generik B, berturut-turut 3 hari dan 4 hari. Berdasarkan hasil penelitian disimpulkan bahwa seftazidim generik B lebih cost-effective dibanding generik A.

Costs of administration of intravenous (IV) therapies in early versus late stage breast cancer in a US population

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6588-6588
Author(s):  
G. B. Kruse ◽  
M. M. Amonkar ◽  
D. Skonieczny ◽  
G. L. Smith
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Late Stage ◽  
Early Stage ◽  
Administrative Claims ◽  
Cancer Drugs ◽  
Breast Cancer Patients ◽  
Related Services ◽  
Specialized Equipment ◽  
Cost Components

6588 Background: There are significant costs associated with IV administration of cancer drugs ranging from adverse events associated with the administration to the need for specialized equipment, supplies and personnel time. This study utilized a novel provider-payer contract database to compare the cost components of providing IV therapy to women with early and late stage breast cancer. Methods: Women diagnosed with breast cancer (ICD-9 code 174) between 01/01/2003 and 05/31/2006 and receiving IV monotherapy were identified from an administrative claims database of >60 multi-specialty medical practices/clinics (additional ICD-9 codes 196–198 used to identify late stage breast cancer). Costs were estimated on a per IV administration visit basis using the allowable amount for a claim which closely represents the actual amount paid to providers. Published literature was used to categorize the various billable cost components. Results: 1,393 early and 828 late stage breast cancer patients receiving any of 11 IV breast cancer drugs were identified. The costs breakdown by category for all drugs and for the 2 most commonly used drugs, per IV administration visit, is presented in the table . Conclusions: Costs associated with administration of IV therapies and other visit-related services constituted more than 36% of total costs for early stage and 41% of total costs for late stage breast cancer patients. These costs represent a significant cost burden to payers. Maximization of valuable resources could be effected by increased use of effective oral therapies for treatment of breast cancer. [Table: see text] [Table: see text]

scholarly journals Cost-effectiveness of using protons in breast cancer patients aiming at reducing cardiotoxicity: A risk-stratification analysis

2021 ◽  
Author(s):  
Guo Li ◽  
Yun-Fei Xia ◽  
Yi-Xiang Huang ◽  
Deniz Okat ◽  
Bo Qiu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Cardiac Risk ◽  
Cardiac Risk Factor ◽  
General Level ◽  
Breast Cancer Patients ◽  
Intensity Modulated

Abstract Purpose Incidental exposure of heart to ionizing irradiation is associated with an increased risk of ischemic heart disease (IHD) in breast cancer patients after radiotherapy. Intensity-modulated proton radiation therapy (IMPT) offers a promise in limiting the mean heart dose (MHD) in breast irradiation to a negligible level. However, the uncertainty in cost-effectiveness hinders its use. This cost-effectiveness analysis aims to identify patients in appropriate risk groups as targets for IMPT. Methods A Markov decision model was designed to evaluate the cost-effectiveness of IMPT versus intensity-modulated photon-radiation therapy (IMRT) in reducing the irradiation-related IHD risk. Baseline evaluation was performed on 50-year-old women patient without preexisting cardiac risk factor (CRF). Stratified for preexisting cardiac risk and photon MHD, cost-effective scenarios under different proton cost and willingness-to-pay (WTP) were identified for 40-, 50- and 60-year-old patients. Results With baseline set-ups, incremental effectiveness (IE) ranged from 0.025 quality-adjusted life-year (QALY) to 0.135 QALY when photon MHD varied from 3 to 16 Gy; IE increased from 0.043 QALY to 0.964 QALY when preexisting cardiac risk increased from the baseline level to its 10 times. IMPT was not cost-effective to patients without preexisting CRF. At the WTP of China, once proton cost reduced to $20,000, IMPT would be cost-effective to ≤ 50-year-old women patients having preexisting cardiac risk of general-population level. Conclusion Patient’s preexisting cardiac risk level should be a main consideration for the clinical decision of using protons; protons may become cost-effective to general-level patients if a substantial decrease in proton cost occurs in the future.

scholarly journals Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients

2020 ◽  
Author(s):  
Yibo Xie ◽  
Beibei Guo ◽  
Rui Zhang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Tumor Control ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Life Years ◽  
Mixed Beam

Abstract Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT).Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER), and SOC was used as the reference.Results: For the patient cohort, IMRT is the most cost-effective technique with an ICER value of 27,310 $/QALY, and IMPT has the highest ICER of 74,564 $/QALY. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY.Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be the most cost-effective option for PMRT patients.

scholarly journals Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients

2020 ◽  
Author(s):  
Yibo Xie ◽  
Beibei Guo ◽  
Rui Zhang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Patients ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Breast Cancer Patients ◽  
Intensity Modulated ◽  
Life Years ◽  
Mixed Beam ◽  
Effective Option

Abstract Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT). Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER), and SOC was used as the reference. Results: For the patient cohort, IMRT is the most cost-effective technique as it dominates NC-VMAT, MA-VMAT, MIXED, and has ICER of 27,310 $/QALY, 19,081 $/QALY and 3,067 $/QALY compared with SOC, STD-VMAT and TOMO, respectively. IMPT has the highest ICER of 74,564 $/QALY and 151,741 $/QALY compared with SOC and IMRT, which shows IMPT is the least cost-effective option. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY. Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be the most cost-effective option for PMRT patients.

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