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J Oncol Pract. 2014 Mar;10(2):e86-92. doi: 10.1200/JOP.2013.001142. Epub 2013 Dec 10.

Cost effectiveness of a survivorship care plan for breast cancer survivors.

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University of Ottawa; Ottawa Hospital Research Institute; Applied Health Economics Research Unit, Ottawa; Ontario Institute for Cancer Research; University of Toronto, Toronto; Ontario Clinical Oncology Group; McMaster University; and Juravinski Regional Cancer Centre, Hamilton, Ontario, Canada.



Survivorship care plans (SCPs) are recommended for patients who have completed primary treatment and are transitioning to routine follow-up care. However, SCPs may be costly, and their effectiveness is unproven. The study objective was to assess the cost effectiveness of an SCP for breast cancer survivors transitioning to routine follow-up care with their own primary care physician (PCP) using data from a recent randomized controlled trial (RCT).


Resource use and utility data for 408 patients with breast cancer enrolled in the RCT comparing an SCP with standard care (no SCP) were used. The intervention group received a 30-minute educational session with a nurse and their SCP, and their PCPs received the SCP plus a full guideline on follow-up. Analysis assessed the societal costs and quality-adjusted life years (QALYs) for the intervention group and the control group over the 2-year follow-up of the RCT. Uncertainty concerning cost effectiveness was assessed through nonparametric bootstrapping and deterministic sensitivity analysis.


The no-SCP group had better outcomes than the SCP group: total costs per patient were lower for standard care (Canadian $698 v $765), and total QALYs were almost equivalent (1.42 for standard care v 1.41 for the SCP). The probability that the SCP was cost effective was 0.26 at a threshold value of a QALY of $50,000. A variety of sensitivity analyses did not change the conclusions of the analysis.


This SCP would be costly to introduce and would not be a cost effective use of scarce health care resources.

[Indexed for MEDLINE]

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