Improving the quality of abstract reporting for economic analyses in oncology

109 Background: Increasing costs of cancer drugs underscore the importance of EA, which convey key information about the relative costs and benefits of new interventions. Although guidelines for abstracts exist for phase I, II, and III oncology trials, similar recommendations for EA are lacking. Our objectives were to 1) identify items considered to be essential for EA abstracts; 2) evaluate the quality of EA abstracts submitted to ASCO, ASH, and ISPOR meetings; and 3) propose guidelines for future reporting. Methods: Health economic experts were surveyed and asked to rate each of 24 possible EA elements on a 5-point Likert scale. A scoring system for abstract quality (0=poor and 100=excellent) was devised based on EA elements with an average expert rating ≥ 3.5. All EA abstracts from ASCO (‘97–‘09), ASH (‘04–‘09) and ISPOR (‘97–‘09) were reviewed and assigned a quality score. Results: Of 99 experts surveyed, 50 (51%) responded. Characteristics of respondents: average age = 53; male = 78%; US / Europe / Canada = 54% / 28% / 18%. A total of 216 abstracts were reviewed: ASCO 53%, ASH 14% and ISPOR 33%. Median quality score was 75 (range 48 to 93), but notable deficiencies were observed. For instance, the cost perspective of the EA was reported in only 61% of abstracts, while the time horizon was described in only 47%. An association was seen between year of presentation and overall quality of abstracts (p=0.001), with those from recent years demonstrating better quality scores. There were also disparities in quality scores among EA of different cancer sites (p=0.005). Conclusions: Quality of EA abstracts for oncology has improved over time, but there is room for improvement. Abstracts may be enhanced using guidelines derived from our survey of experts (see table). [Table: see text]

Download Full-text

The economic benefits of rehabilitation for neurological conditions

Oxford Textbook of Neurorehabilitation ◽

10.1093/med/9780198824954.003.0003 ◽

2020 ◽

pp. 23-30

Author(s):

Rory J. O’Connor

Keyword(s):

Psychological Functioning ◽

Cost Effective ◽

Economic Benefits ◽

Economic Evaluations ◽

Healthcare Intervention ◽

Effective Interventions ◽

Neurological Conditions ◽

Economic Analyses

Rehabilitation programmes are highly cost-effective interventions that restore people’s independence, dignity, and quality of life. In the past there was an impression that they appeared expensive, which resulted in a lack of enthusiasm to develop them by funding bodies and commissioners. However, the evidence demonstrating the long-term cost-effectiveness of rehabilitation is robust. Many people with long-term neurological conditions will live for many years after the onset of the condition and investment in their physical and psychological functioning early on will, over that person’s lifetime, will result in substantial savings. Nevertheless, calculating economic evaluations can be complicated and the correct measure must be chosen to identify the change produced by the rehabilitation intervention. These data must then be handled appropriately, and any ancillary costs included. The economic impact of the rehabilitation programme is wider than a purely healthcare intervention and will include potential earnings and reduced costs to social care. The economic analyses will also include housing, education, and vocational outcomes, and the effect of the long-term condition on family members who may have a caring role.

Download Full-text

Methodological quality of radiology economic analyses

European Radiology ◽

10.1007/pl00014091 ◽

2000 ◽

Vol 10 (S3) ◽

pp. S349-S353 ◽

Cited By ~ 1

Author(s):

C. C. Blackmore

Keyword(s):

Methodological Quality ◽

Economic Analyses

Download Full-text

Costing Methodology and Key Drivers of Health Care Costs Within Economic Analyses in Musculoskeletal Community and Primary Care Services: A Systematic Review of the Literature

Journal of Primary Care & Community Health ◽

10.1177/2150132719899763 ◽

2020 ◽

Vol 11 ◽

pp. 215013271989976

Author(s):

Roanna Burgess ◽

James Hall ◽

Annette Bishop ◽

Martyn Lewis ◽

Jonathan Hill

Keyword(s):

Primary Care ◽

Health Care ◽

Health Care Costs ◽

Community Settings ◽

Outpatient Visits ◽

Key Drivers ◽

Gp Visits ◽

Economic Analyses ◽

Care Costs

Background: Identifying variation in musculoskeletal service costs requires the use of specific standardized metrics. There has been a large focus on costing, efficiency, and standardized metrics within the acute musculoskeletal setting, but far less attention in primary care and community settings. Objectives: To ( a) assess the quality of costing methods used within musculoskeletal economic analyses based primarily in primary and community settings and ( b) identify which cost variables are the key drivers of musculoskeletal health care costs within these settings. Methods: Medline, AMED, EMBASE, CINAHL, HMIC, BNI, and HBE electronic databases were searched for eligible studies. Two reviewers independently extracted data and assessed quality of costing methods using an established checklist. Results: Twenty-two studies met the review inclusion criteria. The majority of studies demonstrated moderate- to high-quality costing methods. Costing issues included studies failing to fully justify the economic perspective, and not distinguishing between short- and long-run costs. Highest unit costs were hospital admissions, outpatient visits, and imaging. Highest mean utilization were the following: general practitioner (GP) visits, outpatient visits, and physiotherapy visits. Highest mean costs per patient were GP visits, outpatient visits, and physiotherapy visits. Conclusion: This review identified a number of key resource use variables that are driving musculoskeletal health care costs in the community/primary care setting. High utilization of these resources (rather than high unit cost) appears to be the predominant factor increasing mean health care costs. There is, however, need for greater detail with capturing these key cost drivers, to further improve the accuracy of costing information.

Download Full-text

Cost-Effectiveness Analysis (CEA) of Sequential Treatment with Tyrosine Kinase Inhibitors (TKIs) for Chronic Myelogenous Leukemia (CML)

Blood ◽

10.1182/blood.v124.21.2607.2607 ◽

2014 ◽

Vol 124 (21) ◽

pp. 2607-2607

Author(s):

John Whalen ◽

Ipek Stillman ◽

Apoorva Ambavane ◽

Eugene Felber ◽

Dinara Makenbaeva ◽

...

Keyword(s):

Research Funding ◽

Lifetime Cost ◽

Chronic Phase ◽

Cytogenetic Response ◽

High Dose ◽

Employment Equity ◽

Equity Ownership ◽

Tki Treatment ◽

Economic Analyses

Abstract Background: Imatinib has been approved for treatment of newly diagnosed CML since 2001. For patients failing imatinib, other treatment options such as dasatinib, nilotinib, bosutinib, and high-dose imatinib are recommended. Previous economic analyses assumed that patients are treated until progression, despite guidelines recommending changing treatments for non-responders. The objective was to perform a CEA of sequential treatment with 2nd line TKIs, from a commercial payer perspective in the United States (US). Methods: A Markov-cohort model was used to simulate lifetime treatment costs and health outcomes (discounted 3.0% per annum) for patients resistant or intolerant to 1st line imatinib. It compared six treatment sequences, starting from 2nd line (shown in the results table). The model included five health states: chronic phase 2nd line TKI, chronic phase 3rd line TKI, chronic phase no TKI, post-progression, and death. After 12 months of TKI treatment, patients without a major molecular or complete cytogenetic response (MMR or CCyR) moved to the next line of therapy (per NCCN guidelines). Patients could also move to the next treatment line if they lost MMR or CCyR, or discontinued due to drug-related toxicity. Data for response achievement, risks of progression, death, adverse events, and discontinuation were primarily based on data in published trials. Due to the lack of head-to-head studies for dasatinib vs. nilotinib in 2nd line, and a lack of time-to-response data for all three 2nd line treatments, MMR and CCyR rates were interpolated from available data points in 2nd line, while dasatinib and nilotinib rates were assumed to be equal in 3rd line. Dasatinib and imatinib progression, loss of response, and survival rates for 2nd line responders were assumed equal, due to data limitations. In each health state, patients accrued drug costs, resource use (related to monitoring, AE management, and disease management) costs and quality-adjusted life years (QALYs). Resource use, cost, and utility estimates were based on FDA labels, RedBook, Medicare and AHRQ Healthcare Cost Utilization Project data, and published economic analyses. Multi-way uncertainty analyses evaluated key contributors to uncertainty in the results, by testing various assumptions for probabilities of discontinuation, response, loss of response, progression, and survival. Results: The model predicts that 2nd line dasatinib provides increased survival (ΔLYs = ~0.4-2.6 years) and QALYs (ΔQALYs = ~0.4-2.8 years) in all patient groups when compared with 2nd line high-dose imatinib or nilotinib sequences. Also, 2nd line dasatinib was more costly (ΔLifetime Costs = ~$65,000 - $225,000) than high-dose imatinib and nilotinib, primarily due to longer survival and corresponding longer time on TKI treatment. In ±20% univariate sensitivity analyses, the model was most sensitive to 2nd line progression and survival estimates. Conclusions: This analysis suggests that dasatinib may be associated with increased life expectancy and quality of life when compared with high dose imatinib or nilotinib, among patients who are resistant or intolerant to 1st line imatinib, primarily based on higher cytogenetic response rates observed in studies of dasatinib. Other studies have shown improved quality of life for responders, and landmark analyses have shown improved survival for patients achieving cytogenetic response, but head-to-head clinical studies of sequential use of dasatinib and nilotinib are needed to confirm the model result. Based on the threshold of $150,000/QALY, dasatinib can be considered cost-effective in the US. Results Table: Sequence # Sequence 1 Sequence 2 Sequence 3 Sequence 4 Sequence 5 Sequence 6 1st line (not modeled – assumes 1st line imatinib for all sequences) 2nd line DAS NIL HDI DAS NIL HDI 3rd line NIL DAS NIL BOS BOS DAS Imatinib-resistant population LYs 7 6.5 4.5 7.3 6.8 4.5 QALYs 5.9 5.4 3.6 6.2 5.7 3.6 Lifetime Cost $497,391 $431,346 $270,308 $496,897 $431,084 $270,051 ICERs: DAS followed by NIL vs. NIL followed by DAS - $129,139 DAS followed by NIL vs. HDI followed by NIL - $96,356 Imatinib-intolerant population LYs 7.8 7.1 -- 8.1 7.4 -- QALYs 6.7 6.0 -- 7.0 6.3 -- Lifetime Cost $599,270 $509,456 -- $598,766 $509,174 -- ICERs: DAS followed by NIL vs. NIL followed by DAS - $125,800 BOS=bosutinib; DAS=dasatinib; HDI= high-dose imatinib; NIL=nilotinib; ICER=incremental cost-effectiveness ratio Disclosures Whalen: Evidera, Inc.: Consultancy, Employment; Bristol-Myers Squibb: Research Funding. Stillman:Evidera, Inc.: Consultancy, Employment; Bristol-Myers Squibb: Research Funding. Ambavane:Evidera, Inc.: Consultancy, Employment; Bristol-Myers Squibb: Research Funding. Felber:Bristol-Myers Squibb: Employment, Equity Ownership. Makenbaeva:Bristol-Myers Squibb: Employment, Equity Ownership. Bolinder:Bristol-Myers Squibb: Employment, Equity Ownership.

Download Full-text

The quality of phase I trial (P1T) abstracts submitted to ASCO meetings

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.6532 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 6532-6532

Author(s):

E. L. Strevel ◽

N. Chau ◽

G. R. Pond ◽

A. J. Murgo ◽

S. P. Ivy ◽

...

Keyword(s):

Drug Development ◽

Maximum Tolerated Dose ◽

Quality Score ◽

Electronic Survey ◽

Governmental Agencies ◽

Expert Rating ◽

Expert Ratings ◽

Oral Presentations ◽

Abstract Reporting

6532 Background: Conference abstracts of P1T communicate important information of anticancer drug development. Our objectives were to determine elements considered by experts as essential for good P1T abstract reporting, to assess the quality of P1T abstracts submitted to ASCO meetings, and to propose guidelines for future reporting. Methods: Elements important for P1T abstract reporting were determined by a survey of experts in developmental therapeutics, and a scoring system for abstract quality was generated. All P1T abstracts published in ASCO Proceedings from 2002–2006 were reviewed, and a quality score was assigned. Results: An electronic survey was sent twice to 69 experts, with a response rate of 39% (27/69). Characteristics of the 27 experts were: average age = 48; male = 74%, USA:Europe:Canada = 78%:15%:7%; 89% had 10+ years experience in drug development; 93% from academic institutions versus 7% from governmental agencies; 56% currently involved in clinical research versus 44% in translational research. Experts were asked to rate each of 37 elements using a five-point Like rt scale, and elements with average expert ratings over 3.75 were included in the final quality score calculations. A total of 920 P1T abstracts over 5 years were reviewed. A positive and linear association was observed between average expert rating of the elements and proportion of P1T abstracts that included those elements (Spearman correlation coefficient, ρ=0.65). The median quality score for all 920 abstracts was 65% (range 26%–95%, SD 12.6%). Deficiencies existed in abstract reporting; for instance, dose-limiting toxicity was described in only 63% of abstracts, while recommended dose or maximum tolerated dose was reported in only 38%. A significant association between year of presentation was found (ρ=0.36, P<0.001), with later years possessing better quality scores. The quality score was also statistically significant as a predictor of type of presentation (odds ratio 0.20, 95% CI 0.08–0.54, P=0.002), with oral presentations having the highest scores. Conclusion: The quality of P1T abstract reporting at ASCO has improved over time, although there is room for optimization. The quality of P1T abstract reporting may be enhanced using guidelines derived from our expert consensus. No significant financial relationships to disclose.

Download Full-text