Cost, Cost-effectiveness and Survival Impact Assessment for A Better Management of Colorectal Cancer Patients: A Single Centre Comprehensive Analysis.

Adrian Ionut Gana, Cecilia Bica, Cristina Alexandra Ciocan, Elena Ofelia Moșteanu, Teodora Atena Pop, Ioana Berindan-Neagoe, Ioan Cătălin Vlad, Patriciu Andrei Achimaș-Cadariu
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Abstract

Background and aims: The world healthcare systems are currently challenged by the accumulating burden of colorectal cancer (CRC), and cancer registries represent an important segment for prevention and developing management plans, being useful in providing data regarding incidence, mortality, survival, exposure to carcinogens, lifestyle. Retrospective data from CRC patients in Romania was used to assess survival impact, costs, and cost-effectiveness considering three crucial aspects: pharmacology, chemo-/radio-therapy, and hospitalization for care and management of these patients.

Methods: 423 CRC patients from the Institutional Cancer Registry of the Prof. Dr. Ion Chiricuta Institute of Oncology in Cluj-Napoca, Romania were included in the cost analysis. For the assessment of cost efficiency of the primary treatment strategy, we collected data regarding direct medical costs associated with surgery, radiotherapy and medication, as well as the afferent day or continuous hospitalization, for each patient. For the cost-effectiveness analysis we used the method of estimation of incremental cost-effectiveness ratio.

Results: No compelling differences regarding survival time were observed in different therapeutic options per CRC stage. Substantial differences in cost effectiveness among therapeutic options in the same stage of several thousand Euros in stages I-III, while for stage IV, the ICER was more than 100,000 Euros per life saved.

Conclusions: Systematic evaluation of costs, cost-effectiveness, and survival impact, helps healthcare systems can make informed decisions to improve the management of colorectal cancer patients, optimizing outcomes while minimizing financial burden.

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更好地管理结直肠癌患者的成本、成本效益和生存影响评估:单中心综合分析
背景和目的:癌症登记是预防和制定管理计划的重要环节,可提供有关发病率、死亡率、存活率、致癌物暴露和生活方式的数据。我们使用罗马尼亚 CRC 患者的回顾性数据来评估生存影响、成本和成本效益,其中考虑到三个关键方面:药理学、化疗/放疗以及住院治疗和管理这些患者。为了评估主要治疗策略的成本效益,我们收集了每位患者与手术、放疗和药物治疗相关的直接医疗费用,以及感染日或连续住院的相关数据。在成本效益分析中,我们采用了估算增量成本效益比的方法:结果:在每个 CRC 分期的不同治疗方案中,没有观察到令人信服的生存时间差异。I-III期不同治疗方案的成本效益差异巨大,在几千欧元,而IV期每挽救一条生命的ICER超过10万欧元:对成本、成本效益和生存影响进行系统评估,有助于医疗系统做出明智决策,改善对结直肠癌患者的管理,在优化疗效的同时最大限度地减轻经济负担。
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