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Page 1: Breast cancer survivorship care plan not cost effective in Canada

PharmacoEconomics & Outcomes News 694, p3-4 - 18 Jan 2014

Breast cancer survivorship careplan not cost effective in CanadaA survivorship care plan (SCP) for breast cancer

survivors in Canada, is not cost effective compared withusual care, according to a study published in the Journalof Oncology Practice.

This study, done from both a healthcare system andsocietal perspective, used data from a publishedrandomised clinical trial that compared SCP with usualcare in 408 patients. SCP consisted of a package with atreatment summary, a patient-version of follow-upguidelines, and information about local relevantsupportive care resources. The trial did not find anysignificant difference in outcomes between the twogroups. For the current analysis, the Short Form 36general health status questionnaire was administered atbaseline, and at 3, 6, 12, 18 and 24 months, while utilityvalues were derived using nonparametric Bayesianpreference weights. Costs, reported in 2011 Canadiandollars, included physician visits, diagnostic andlaboratory tests, patient travel costs and lostproductivity, and additional costs associated with theSCP. The cost of the SCP was estimated at $Can59.96per patient.

Although there was little difference in the costs ofphysician visits, diagnostic and laboratory tests, patienttravel costs and lost productivity between groups,inclusion of the cost of the SCP resulted in higher totalcosts for patients in the SCP group ($765 vs $695).Similarly, little difference was found between the twogroups in QALY changes from baseline – 1.42 for usualcare and 1.41 for SCP, suggesting that standard care wasmore cost effective than SCP.

With an estimated annual cost of $1.4 million,implementation of the SCP is thus not recommended,while the authors suggest that greater effectivenessmight be achieved through better identification ofpatients with greater needs, using a needs-basedstratified approach.Coyle D, et al. Cost Effectiveness of a Survivorship Care Plan for Breast CancerSurvivors. Journal of Oncology Practice : 10 Dec 2013. Available from: URL:http://dx.doi.org/10.1200/JOP.2013.001142 803097455

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PharmacoEconomics & Outcomes News 18 Jan 2014 No. 6941173-5503/14/0694-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved

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