Cost‐effective management of colon and rectal cancer

Abstract

Health care costs in the United States of America continue to rise. Legislators, economists and third party payers are becoming increasingly concerned with intervention outcomes and the distribution of resources. It is the responsibility of the medical profession to assume a leading role in assessing the cost-effectiveness of health care interventions. Although many physicians perform informal cost-effectiveness analyses on a daily basis, health economists employ a variety of more complex methodologies. This article will attempt to provide physicians with an understanding of the value and limitations of the tools used in formal cost-effectiveness analyses and demonstrate how these tools may be applied to the management of colon and rectal cancer.

Screening and the costs of treating colorectal cancer

“…Perhaps most important of all, the costs used in the US evaluations are not, technically speaking, costs at all; they are charges or prices levied by (mostly) private hospitals and accepted as valid by the financial institutions responsible for payment (Finkler, 1982). Evidence suggests that the intensity and duration of hospital treatment for colorectal cancer in the USA (which is the principal determinant of total costs) varies with the nature of the patient's health insurance package (Heine & Rothenberger, 1991). Different packages thus permit hospitals to levy different charges on their customers.…”

Economic evaluation of cancer treatments

“…Cancer not only accounts for a major burden of mortality and morbidity (about one third of all mortality in the Netherlands, for example), its economic impact is also considerable (Koopmanschap et al, 1991;Broder, 1991;Yarbro, 1991 (Yarbro, 1991;Heine and Rothenberger, 1991;Berg, 1991) as the costs per case are usually high, and expected benefits are still small for large groups of patients (Hancock, 1992). This article describes some theoretical aspects of economic evaluation and some practical issues of economic evaluation are combined with a clinical trial (Dmmmond and Davies, 1991).…”

Economic Evaluation of Cancer Treatments

“…One of the methodological innovations has been the introduction of quality of life outcome measures in clinical evaluation research, in addition to the use of standard fixed year survival rates. Moreover, the apparent trade-off between survival prolongation and quality of life improvement has urged the development of combined m0l1ality-morbidity measures (Goldhirsch et al, 1989 (Yarbro, 1991;Heine and Rothenberger, 1991;Berg, 1991) as the costs per case are usually high, and expected benefits are still small for large groups of patients (Hancock, 1992). This article describes some theoretical aspects of economic evaluation and some practical issues of economic evaluation are combined with a clinical trial (Dmmmond and Davies, 1991).…”