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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.

Author information

1
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.

Abstract

PURPOSE:

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).

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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

PMID:
24326740
DOI:
10.1200/JOP.2013.001142
[Indexed for MEDLINE]

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