Are We Lacking Economic Evaluations in Gastric Cancer Treatment?

Mahar, Alyson; El-Sedfy, Abraham; Brar, Savtaj; Johnson, Ana; Coburn, Natalie

doi:10.1007/s40273-014-0215-1

Cited by 7 publications

(8 citation statements)

References 23 publications

(33 reference statements)

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“…A review of the economic data available on GC management shows that, even though GC is a major clinical and financial burden, only a few evaluations of the costs of GC management and cost-effectiveness were available, most of which were conducted in Asia [18–21, 25, 27, 28, 31, 35, 38, 44, 88, 89, 93, 94]. Moreover, few studies were conducted according to high-quality standards and the reported data are not always clear [30]. The cost of GC management per patient is generally higher than the cost for other cancers [27, 28, 36].…”

Section: Resultsmentioning

confidence: 99%

Targeted literature review of the global burden of gastric cancer

Casamayor¹,

Morlock²,

Maeda³

et al. 2018

ecancer

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Gastric cancer (GC) and gastroesophageal junction cancers (GEJCs) are the third leading cause of cancer-related death worldwide. Although several studies have evaluated the epidemiology and management of GC and GEJC, to our knowledge, no global estimates of the economic burden of GC and GEJC have yet been reported. This targeted literature review was conducted to summarise the epidemiology and management of GC and GEJC and to estimate its global economic and humanistic burden.The incidence of GC and GEJC is highest in Eastern Asia, several South and Central American countries and Central and Eastern Europe and lowest in North America and Africa. Prognosis is generally poor; the global 5-year survival rate is 5%–10% in advanced stages. Patients with GC and GEJC have more severe symptoms compared with patients with other cancers, and health-related quality of life (HRQoL) worsens as the disease progresses. Given the rapid progression of GC and GEJC at advanced stages, chemotherapy, despite its toxicity, improves HRQoL compared with best supportive care.The costs of GC/GEJC are generally higher than for other cancers; in the US, the average annual cost per patient between 1998 and 2003 was 46,501 USD, compared with 29,609 USD and 35,672 USD for colorectal and lung cancer, respectively. Based on the 2012 incidence data and average costs per patient, estimates of the annual financial burden of GC and GEJC revealed great regional differences. Japan and Iran had the highest (8,492 million USD) and lowest (27 million USD) costs for 2017, respectively, while the estimate for the US was 3,171 million USD. The overall annual cost of GC and GEJC estimated for 2017 in a geographic area including Europe (France, Germany, Italy, Spain and the UK), Asia (Iran, Japan and China), North America (Canada and the US) and Australia was 20.6 billion USD.

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Section: Resultsmentioning

confidence: 99%

Targeted literature review of the global burden of gastric cancer

Casamayor¹,

Morlock²,

Maeda³

et al. 2018

ecancer

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“…Another international survey reported that the willingness‐to‐pay value for an additional quality‐adjusted life‐year of survival in a perfect health status was 68 million KRW in Korea . There have been few reports using a high‐quality methodology for the utility score of disability‐adjusted life‐year or quality‐adjusted life‐year in gastric cancer, and there have been none for laparoscopic gastrectomy . Previous studies suggested utility scores of 0.81 for open postgastrectomy, 0.68 to 0.797 for usual chemotherapy, and 0.6 for disease progression or terminal care for patients with gastric cancer in different countries .…”

Section: Discussionmentioning

confidence: 99%

National cancer screening program for gastric cancer in Korea: Nationwide treatment benefit and cost

Suh

Lee

Woo

et al. 2020

Cancer

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BACKGROUND:The purpose of this study was to evaluate the nationwide benefit and cost of the national cancer screening program (NCSP) for gastric cancer treatment. METHODS: For this nationwide, population-based study, the Korean National Health Insurance Big Data Base, which included gastric cancer-related treatment information and the costs for all patients with gastric cancer who were 40 years old or older between 2004 and 2013, was restructured. Patients with gastric cancer who participated in the NCSP at least once (the screening group) were compared with those who did not participate in the NCSP (the nonscreening group). RESULTS: The screening group (n = 116,775) spent significantly less on medical care expenses than the nonscreening group (n = 74,927) during the 5 years since the initial treatment (P < .0001). The screening group presented a significantly better prognosis for 5 and 9 years than the nonscreening group (P < .0001). The screening group revealed a 41% decreased hazard ratio (P < .0001) for death in comparison with the nonscreening group; the prognostic benefit became more obvious when treatment was started within the first 4 months after screening. The age-standardized mortality rate ratio of the screening group versus the nonscreening group was 0.62 (P < .0001). The NCSP for gastric cancer required an average of 22,169,769 Korean Republic won (US $20,309) for 1 life-year saved, which was less than the average gross domestic product (GDP) per capita in Korea. CONCLUSIONS: The screening group had significantly lower medical care expenses and showed a significantly better prognosis than the nonscreening group. On the basis of the GDP per capita, the NCSP for gastric cancer was cost-effective for treatment prognosis.

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“…Esophagogastric cancer (EGC) is both highly fatal and one of the most expensive cancers to treat on a per-patient basis [10][11][12][13]. Care by high-volume providers has recently been independently associated with superior overall survival for EGC patients (hazard ratio-HR 0.89; 95% confidence interval-95%CI 0.84-0.93) [6].…”

Section: Introductionmentioning

confidence: 99%

Economic impacts of care by high-volume providers for non-curative esophagogastric cancer: a population-based analysis

et al. 2019

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Background Esophagogastric cancer (EGC) is one of the deadliest and costliest malignancies to treat. Care by high-volume providers can provide better outcomes for patients with EGC. Cost implications of volume-based cancer care are unclear. We examined the cost-effectiveness of care by high-volume medical oncology providers for non-curative management of EGC. Methods We conducted a population-based cohort study of non-curative EGC over 2005-2017 by linking administrative datasets. High-volume was defined as ≥ 11 patients/provider/year. Healthcare costs ($USD/patient/month-survived) were computed from diagnosis to death or end of follow-up from the perspective of the healthcare system. Multivariable quantile regression examined the association between care by high-volume providers and costs. Sensitivity analyses were conducted by varying costing horizons and high-volume definitions. Results Among 7011 non-curative EGC patients, median overall survival was superior with care by high-volume providers with 7.0 (IQR 3.3-13.3) compared to 5.9 (IQR 2.6-12.1) months (p < 0.001) for low-volume providers. Median costs/patient/ month-lived were lower for high-volume providers ($5518 vs. $5911; p < 0.001), owing to lower inpatient acute care costs, despite higher medication-associated and radiotherapy costs. Care by high-volume providers was independently associated with a reduction of $599 per patient/month-lived (95% confidence interval − 966 to − 331) compared to low-volume providers. The incremental cost-effectiveness ratio was − 393. Care by high-volume providers remained the dominant strategy when varying the costing horizon and the high-volume definition. Conclusion Care by high-volume providers for non-curative EGC is associated with superior survival and lower healthcare costs, indicating a dominant strategy that may provide an opportunity to improve cost-effectiveness of care delivery.

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Are We Lacking Economic Evaluations in Gastric Cancer Treatment?

Cited by 7 publications

References 23 publications

Targeted literature review of the global burden of gastric cancer

Targeted literature review of the global burden of gastric cancer

National cancer screening program for gastric cancer in Korea: Nationwide treatment benefit and cost

Economic impacts of care by high-volume providers for non-curative esophagogastric cancer: a population-based analysis

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