Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Yang, Sheng‐An; Lai, Ching Han; Kuo, Chia Wei; Lin, Chien‐Chung; Lai, Wu‐Wei; Wang, Jung‐Der

doi:10.3390/ijerph18084040

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Nevertheless, the estimated rebiopsy rate was 5.0%, and the complication rate after rebiopsy was approximately 4.4% according to a previous report. 36 As such, the effect of downstream complications on the results seemed to be minimal. Last, an emerging biomarker of tumor mutation burden was not considered in our study.…”

Section: Discussionmentioning

confidence: 95%

Economic Analysis of Exclusionary EGFR Test Versus Up-Front NGS for Lung Adenocarcinoma in High EGFR Mutation Prevalence Areas

Yang

Yeh

Chen

et al. 2022

Journal of the National Comprehensive Cancer Network

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Background: This study sought to determine whether exclusionary EGFR mutation testing followed by next-generation sequencing (NGS) is a cost-efficient and timely strategy in areas with high prevalence rates of EGFR mutation. Methods: We developed a decision tree model to compare exclusionary EGFR testing followed by NGS and up-front NGS. Patients entered the model upon diagnosis of metastatic lung adenocarcinoma. Gene alterations with FDA-approved targeted therapies included EGFR, ALK, ROS1, BRAF, RET, MET, NTRK, and KRAS. Model outcomes were testing-related costs; time-to-test results; monetary loss, taking both costs and time into consideration; and percentage of patients who could be treated by FDA-approved therapies. Stacked 1-way and 3-way sensitivity analyses were performed. Results: Exclusionary EGFR testing incurred testing-related costs of US $1,387 per patient, a savings of US $1,091 compared with the costs of up-front NGS. The time-to-test results for exclusionary EGFR testing and up-front NGS were 13.0 and 13.6 days, respectively. Exclusionary EGFR testing resulted in a savings of US $1,116 in terms of net monetary loss, without a reduction of patients identified with FDA-approved therapies. The EGFR mutation rate and NGS cost had the greatest impact on minimizing monetary loss. Given that the tissue-based NGS turnaround time was shortened to 7 days, up-front NGS testing would become the best strategy if its price could be reduced to US $568 in Taiwan. Conclusions: In areas with high prevalence rates of EGFR mutation, exclusionary EGFR testing followed by NGS, rather than up-front NGS, is currently a cost-efficient strategy for metastatic lung adenocarcinoma.

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Section: Discussionmentioning

confidence: 95%

Economic Analysis of Exclusionary EGFR Test Versus Up-Front NGS for Lung Adenocarcinoma in High EGFR Mutation Prevalence Areas

Yang

Yeh

Chen

et al. 2022

Journal of the National Comprehensive Cancer Network

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“…Moreover, we collected every participant’s marital status, monthly household income and reason for LDCT screening. The modality of procedure, including bronchoscopy, pleuroscopy, needle biopsy and surgical procedures,15 was also recorded. We reviewed the medical records of every participant and non-participant, and comorbidities were scored according to the Charlson Comorbidity Index 16…”

Section: Methodsmentioning

confidence: 99%

Estimating time and transportation costs associated with lung cancer screening and diagnostic lung procedures in Taiwan: a cross-sectional survey in a medical centre

Lin

et al. 2023

BMJ Open

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ObjectivesEarlier research has evaluated the non-medical costs after lung cancer diagnosis. This study estimated the time costs and transportation costs associated with low-dose CT (LDCT) screening and diagnostic lung procedures in Taiwan.DesignCross-sectional study.SettingA tertiary referral medical centre.Participants and interventionsThe study participants were individuals aged 50–80 years who underwent LDCT screening or diagnostic lung procedures between 2021 and 2022. Participants completed a questionnaire including items on time spent on receiving care, time spent on travel and its cost and time taken off from work by the participant and any accompanying caregiver.Outcome measuresTime costs were valued using the age- and sex-specific average daily wage for employed participants/caregivers. Costs of informal healthcare sector consisted of time cost of the participant, transportation cost and time cost of the caregiver.ResultsA total of 209 participants who underwent LDCT screening (n=84) or non-surgical (n=12) or surgical (n=113) diagnostic lung procedures for the first time were enrolled. Considering the purchasing power parity, the average costs of informal healthcare sector were US$126.4 (95% CI 101.6 to 151.2), US$290.7 (95% CI 106.9 to 474.5) and US$749.8 (95% CI 567.3 to 932.4), respectively, for LDCT screening, non-surgical procedures and surgical procedures.ConclusionsThis study estimated time and transportation costs associated with LDCT screening and diagnostic lung procedures, which could be used for future analysis of cost-effectiveness of lung cancer screening in Taiwan.

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Low-dose computed tomography screening, follow-up, and management of lung nodules – An expert consensus statement from Taiwan

Hsu¹,

Chiang²,

Hsu³

et al. 2022

Formosan Journal of Surgery

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Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Cited by 3 publications

References 21 publications

Economic Analysis of Exclusionary EGFR Test Versus Up-Front NGS for Lung Adenocarcinoma in High EGFR Mutation Prevalence Areas

Economic Analysis of Exclusionary EGFR Test Versus Up-Front NGS for Lung Adenocarcinoma in High EGFR Mutation Prevalence Areas

Estimating time and transportation costs associated with lung cancer screening and diagnostic lung procedures in Taiwan: a cross-sectional survey in a medical centre

Low-dose computed tomography screening, follow-up, and management of lung nodules – An expert consensus statement from Taiwan

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