Cost-effectiveness of general practitioner- versus surgeon-led colon cancer survivorship care : an economic evaluation alongside a randomised controlled trial
© 2023. The Author(s)..
PURPOSE: The aim of this study is to assess cost-effectiveness of general practitioner (GP) versus surgeon-led colon cancer survivorship care from a societal perspective.
METHODS: We performed an economic evaluation alongside the I CARE study, which included 303 cancer patients (stages I-III) who were randomised to survivorship care by a GP or surgeon. Questionnaires were administered at baseline, 3-, 6-, 12-, 24- and 36-months. Costs included healthcare costs (measured by iMTA MCQ) and lost productivity costs (SF-HLQ). Disease-specific quality of life (QoL) was measured using EORTC QLQ-C30 summary score and general QoL using EQ-5D-3L quality-adjusted life years (QALYs). Missing data were imputed. Incremental cost-effectiveness ratios (ICERs) were calculated to relate costs to effects on QoL. Statistical uncertainty was estimated using bootstrapping.
RESULTS: Total societal costs of GP-led care were significantly lower compared to surgeon-led care (mean difference of - €3895; 95% CI - €6113; - €1712). Lost productivity was the main contributor to the difference in societal costs (- €3305; 95% CI - €5028; - €1739). The difference in QLQ-C30 summary score over time between groups was 1.33 (95% CI - 0.049; 3.15). The ICER for QLQ-C30 was - 2073, indicating that GP-led care is dominant over surgeon-led care. The difference in QALYs was - 0.021 (95% CI - 0.083; 0.040) resulting in an ICER of 129,164.
CONCLUSIONS: GP-led care is likely to be cost-effective for disease-specific QoL, but not for general QoL.
IMPLICATIONS FOR CANCER SURVIVORS: With a growing number of cancer survivors, GP-led survivorship care could help to alleviate some of the burden on more expensive secondary healthcare services.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Journal of cancer survivorship : research and practice - (2023) vom: 25. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vos, Julien A M [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer survivors |
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| Anmerkungen: |
Date Revised 25.04.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s11764-023-01383-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356012093 |
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| 100 | 1 | |a Vos, Julien A M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cost-effectiveness of general practitioner- versus surgeon-led colon cancer survivorship care |b an economic evaluation alongside a randomised controlled trial |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 25.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a PURPOSE: The aim of this study is to assess cost-effectiveness of general practitioner (GP) versus surgeon-led colon cancer survivorship care from a societal perspective | ||
| 520 | |a METHODS: We performed an economic evaluation alongside the I CARE study, which included 303 cancer patients (stages I-III) who were randomised to survivorship care by a GP or surgeon. Questionnaires were administered at baseline, 3-, 6-, 12-, 24- and 36-months. Costs included healthcare costs (measured by iMTA MCQ) and lost productivity costs (SF-HLQ). Disease-specific quality of life (QoL) was measured using EORTC QLQ-C30 summary score and general QoL using EQ-5D-3L quality-adjusted life years (QALYs). Missing data were imputed. Incremental cost-effectiveness ratios (ICERs) were calculated to relate costs to effects on QoL. Statistical uncertainty was estimated using bootstrapping | ||
| 520 | |a RESULTS: Total societal costs of GP-led care were significantly lower compared to surgeon-led care (mean difference of - €3895; 95% CI - €6113; - €1712). Lost productivity was the main contributor to the difference in societal costs (- €3305; 95% CI - €5028; - €1739). The difference in QLQ-C30 summary score over time between groups was 1.33 (95% CI - 0.049; 3.15). The ICER for QLQ-C30 was - 2073, indicating that GP-led care is dominant over surgeon-led care. The difference in QALYs was - 0.021 (95% CI - 0.083; 0.040) resulting in an ICER of 129,164 | ||
| 520 | |a CONCLUSIONS: GP-led care is likely to be cost-effective for disease-specific QoL, but not for general QoL | ||
| 520 | |a IMPLICATIONS FOR CANCER SURVIVORS: With a growing number of cancer survivors, GP-led survivorship care could help to alleviate some of the burden on more expensive secondary healthcare services | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cancer survivors | |
| 650 | 4 | |a Colon cancer | |
| 650 | 4 | |a Cost–benefit analysis | |
| 650 | 4 | |a Primary health care | |
| 650 | 4 | |a Quality of healthcare | |
| 700 | 1 | |a El Alili, Mohamed |e verfasserin |4 aut | |
| 700 | 1 | |a Duineveld, Laura A M |e verfasserin |4 aut | |
| 700 | 1 | |a Wieldraaijer, Thijs |e verfasserin |4 aut | |
| 700 | 1 | |a Wind, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Sert, Edanur |e verfasserin |4 aut | |
| 700 | 1 | |a Donkervoort, Sandra C |e verfasserin |4 aut | |
| 700 | 1 | |a Govaert, Marc J P M |e verfasserin |4 aut | |
| 700 | 1 | |a van Geloven, Nanette A W |e verfasserin |4 aut | |
| 700 | 1 | |a van de Ven, Anthony W H |e verfasserin |4 aut | |
| 700 | 1 | |a Heuff, Gijsbert |e verfasserin |4 aut | |
| 700 | 1 | |a van Weert, Henk C P M |e verfasserin |4 aut | |
| 700 | 1 | |a Bosmans, Judith E |e verfasserin |4 aut | |
| 700 | 1 | |a van Asselt, Kristel M |e verfasserin |4 aut | |
| 700 | 0 | |a ICARE study group |e verfasserin |4 aut | |
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