Cost Analysis of Palliative Care for Terminally Ill Cancer Patients in the UK After Switching from Weak to Strong Opioids

Abstract

The expected cost of palliative care in the UK healthcare setting ranged from approximately 2500 Pounds to 4000 Pounds (1500 Pounds to 6000 Pounds in the sensitivity analysis) depending on the length of survival after patients switch from weak to strong opioids. Since opioids account for only 2 to 8% of expected costs, factors other than economic issues, such as tolerability profile, patient preference and convenience of use, should form the basis of clinical decision-making between opioids with similar analgesic efficacy.

A comparison of the resources used in advanced cancer care between two different strong opioids: an analysis of naturalistic practice in the UK

“…Notwithstanding this, constipation poses less of a problem than was estimated in our previous study 16 . This difference may be due to the present study being based on naturalistic practice.…”

“…These findings should now be investigated further under more controlled conditions. Previous studies have estimated that patients see primary care clinicians more frequently for their palliative care than our analysis would suggest 16,32 . Reasons for the differences between the various studies are unclear, but might reflect differences between patients who receive different strong opioids.…”

“…Against this background, we previously estimated the costs of palliative care for advanced cancer patients in the UK after they switched from weak to strong opioids 16 . Our previous analysis suggested that neither the choice of opioid nor the management of constipation impacted significantly on either cost or resource use.…”

The potential cost savings of greater use of home- and hospice- based end of life care in England

“…85 Guest, Hart and Cookson (1998) estimate the total cost of managing terminally ill cancer patients in the UK from the time they were switched from a weak to a strong opioid until death. Researchers at the Sheffield School of Health and Related Research (ScHARR) were recently commissioned to develop a model based on health economics to help support decision making on the provision of palliative care service, in support of the preparation by NICE of new national guidelines on the provision of palliative care.…”

Economic Evaluation of Everolimus versus Sorafenib for the Treatment of Metastatic Renal Cell Carcinoma after Failure of First-Line Sunitinib

“…The analysis incorporated a weighted average of postprogression therapies (surgical, pharmacological, radiotherapeutic). Death (termed an absorbing health state) was assigned the cost of endof-life care, which was based on secondary literature (Table 2) [25]. Indirect costs (e.g., lost productivity and cost to caregiver) were not included in the model.…”