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Koinberg I, Engholm GB, Genell A, Holmberg L. A health economic evaluation of follow-up after breast cancer surgery: results of an rct study. Acta Oncol 2009; 48:99-104. [PMID: 18766474 DOI: 10.1080/02841860802314712] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Breast cancer follow-up programmes consume large resources and despite the indications that several alternative approaches could be used effectively, there is no coherent discussion about costs and/or cost-effectiveness of follow-up programmes. PATIENT AND METHODS In a prospective trial there were 264 breast cancer patients, stage I and II, randomised to two different follow-up programmes- PG (physician group) and NG (nurse group). The trial period was 5 years. The women in the two intervention groups did not differ in anxiety and depression, their satisfaction with care, their experienced accessibility to the medical centre or their medical outcome as measured by recurrence or death. The analyses were done from different lists representing costs at three hospitals in Sweden according to the principles of a cost minimization study. RESULTS The cost per person year of follow-up differed between the groups, with 630 euro per person year in PG compared to 495 euro per person year in NG. Thus, specialist nurse intervention with check-ups on demand was 20% less expensive than routine follow-up visits to the physician. The main difference in cost between the groups was explained by the numbers of visits to the physician in the respective study arms. There were 21% more primary contacts in PG than NG. DISCUSSION The difference in cost per year and patient by study arm is modest, but transforms to nearly 900 euro per patient and 5-year period, offering a substantial opportunity for reallocating resources since breast cancer is the most prevalent tumour worldwide.
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Alvegard TA, Borg S, Ferras-Nunez J, Franzen S, Genell A, Malmström PO, Persson U, Wallgren A, Östlund A. The cost-effectiveness of post-operative radiotherapy after breast conservation surgery in stage I-II breast cancer in Sweden. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T. A. Alvegard
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - S. Borg
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - J. Ferras-Nunez
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - S. Franzen
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - A. Genell
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - P.-O. Malmström
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - U. Persson
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - A. Wallgren
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
| | - A. Östlund
- Univ Hosp, Lund, Sweden; The Swedish Institute for Health Economics (IHE), Lund, Sweden; Gothenburg Univ, Gothenburg, Sweden; West Health Care Region, Gothenburg, Sweden; Lund Univ, Lund, Sweden
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