Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-25T04:04:14.570Z Has data issue: false hasContentIssue false
  • English
  • Français

Economic Evaluation of Trends in Cancer Therapy: Marginal or Average Costs?

Published online by Cambridge University Press:  10 March 2009

Maria Goddard  and
John Hutton
Maria Goddard
Affiliation:
University of York
John Hutton
Affiliation:
University of York
Get access Rights & Permissions [Opens in a new window]

Abstract

Evaluating the use of resources as well as outcomes in cancer therapy is increasingly becoming recognized by both clinicians and others as a legitimate and indeed even desirable activity. While this trend is to be welcomed if it facilitates the efficient use of resources for cancer care, there are dangers in applying estimates of unit costs, in particular average costs to the evaluation of trends in practice in cancer therapies. This article examines the use of appropriate measures of average and marginal cost in the economic evaluation of developments in cancer therapy, taking illustrations from radiotherapy and chemotherapy.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Issue 4 , Fall 1991 , pp. 594 - 603
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Atherton, L.The cost of radiotherapy treatments on a linear accelerator. British Journal of Radiology, 1984, 57, 106–07.CrossRefGoogle ScholarPubMed
2.Bates, T.Radiotherapy for bone metastases (editorial). Clinical Oncology, 1989, 1, 57–58.CrossRefGoogle Scholar
3.Bleehan, N., Fayers, P., Girling, D., & Stephens, R.Controlled trial of twelve versus six courses of chemotherapy in the treatment of small-cell lung cancer. British Journal of Cancer, 1989, 59, 584–90.Google Scholar
4.Blitzer, P.Reanalysis of the RTOG study of the palliation of symptomatic osseous metastasis. Cancer, 1985, 55, 1468–72.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
5.Borgelt, B., Gelber, R., Kramer, S., et al. The palliation of brain metastases: Final results of the first two studies by the radiation therapy oncology group. International Journal of Radiation: Oncology, Biology, Physics, 1980, 6, 1–9.Google Scholar
6.Boyle, M., Torrance, G., Sinclair, J., & Horwood, S.Economic evaluation of neonatal intensive care of very-low-birth-weight infants. New England Journal of Medicine, 1983, 308, 1330–37.CrossRefGoogle ScholarPubMed
7.British Institute of Radiology Working Party. First Interim Progress Report on the second British Institute of Radiology fractionation study: Short versus long overall treatment times for radiotherapy of carcinoma of the laryngo-pharynx. British Journal of Radiology, 1989, 62, 450–56.CrossRefGoogle Scholar
8.British Institute of Radiology Working Party. Final report of the general clinical results of the British Institute of Radiology fractionation study of 3F/week versus 5F/week in radiotherapy of carcinoma of the laryngo-pharynx. British Journal of Radiology, 1990, 63, 169–80.Google Scholar
9.Caiman, K., McVie, J., Soukop, M., et al. Cost of outpatient chemotherapy. British Medical Journal, 1978, 1, 493–94.Google Scholar
10.Coates, A., Gebski, V., Bishop, J., et al. Improving the quality of life during chemotherapy for advanced breast cancer. A comparison of intermittent and continuous treatment strategies. New England Journal of Medicine, 1987, 317, 1490-95.Google Scholar
11.Cole, D.A randomized trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clinical Oncology, 1989, 1, 59–62.Google Scholar
12.Crellin, A., Marks, A., & Maher, E.Why don’t British radiotherapists give single fractions of radiotherapy for bone metastases? Clinical Oncology, 1989, 1, 63–66.Google Scholar
13.Drummond, M., Stoddart, G., & Torrence, G.Methods for the economic evaluation of health programmes. Oxford, U.K.: Oxford University Press, 1987.Google Scholar
14. Editorial. Risking less treatment in cancer patients: Lessons from germ-cell tumours. Lancet, 1988, 20, 430–31.Google Scholar
15.Friedlander, M., & Tattersall, M.Counting the costs of cancer therapy. European Journal of Cancer and Clinical Oncology, 1982, 18, 1237–41.Google Scholar
16.Gelber, R., Larson, M., Borgelt, B., & Kramer, S.Equivalence of radiation schedules for the palliative treatment of brain metastases in patients with favourable prognosis. Cancer, 1981, 48, 1749–53.Google Scholar
17.Goddard, M., & Hutton, J.The costs of radiotherapy in cancer treatment. University of York: Centre for Health Economics Discussion Paper 48, 1988.Google Scholar
18.Goel, V., & Detsky, A. A cost-utility analysis of preoperative total parenteral nutrition. International Journal of Technology Assessment in Health Care, 1989, 183–94.Google Scholar
19.Goodman, P., Feld, R., Evans, W., & Pater, J.Cost-effectiveness of cancer chemotherapy: An economic evaluation of a randomized trial in small-cell lung cancer. Journal of Clinical Oncology, 1988, 6, 1537–47.Google Scholar
20.Goodwin, P., Feld, R., Warde, P., & Ginsberg, R.The costs of cancer therapy. European Journal of Cancer and Clinical Oncology, 1990, 26, 223–25.CrossRefGoogle ScholarPubMed
21.Greene, D.The cost of radiotherapy treatment on a linear accelerator. British Journal of Radiology, 1983, 56, 189–91.CrossRefGoogle ScholarPubMed
22.Hanks, G., & Dunlap, K.A comparison of the cost of various treatment methods for early cancer of the prostate. International Journal of Radiation: Oncology, Biology, Physics, 1986, 12, 1879–81.Google ScholarPubMed
23.Houghton, J., & Baum, M.Adjuvant radiotherapy in breast cancer. International Journal of Technology Assessment in Health Care, 1989, 5, 415–22.CrossRefGoogle ScholarPubMed
24.Hughes, D., & McEvedy, M. The effective cost of medical treatment. Management Accounting, 1981, 02, 38–39.Google Scholar
25.Hull, R., Hirsh, J., Sackett, D., & Stoddard, G.Cost-effectiveness of primary and secondary prevention of fatal pulmonary embolism in high-risk surgical patients. Canadian Medical Association Journal, 1982, 127, 990–95.Google ScholarPubMed
26.Jennett, B., & Buxton, M.When is treatment for cancer economically justified? (discussion paper) Journal of the Royal Society of Medicine, 1990, 83, 25–28.CrossRefGoogle ScholarPubMed
27.Jensen, N., & Roesdahl, K.Single-dose irradiation of bone metastases. Ada Radiological Therapy Physics Biology, 1976, 15, 337–39.Google Scholar
28.Leonard, R.Small cell lung cancer. British Journal of Cancer, 1989, 59, 487–90.Google Scholar
29.Madsen, E.Painful bone metastasis: Efficacy of radiotherapy assessed by the patients: A randomised trial comparing 4 Gy×6 versus 10 Gy×2. International Journal of Radiation: Oncology, Biology, Physics, 1983, 9, 1775–79.Google Scholar
30.Maher, E., et al. Who gets radiotherapy? Health Trends, 1990, 22, 78–83.Google Scholar
31.Mattsson, W., Gynning, I., Carlsson, B., & Mauritzon, S.Cancer chemotherapy in advanced malignant disease: A cost benefit analysis. Acta Radiological Oncology, 1979, 18, 509–20.CrossRefGoogle ScholarPubMed
32.Miles, D., Richards, M., & Rubens, R.Cost effectiveness of cancer chemotherapy. Cancer Topics, 1990, 7, 141–42.Google Scholar
33.Motzer, R., Bosl, G., Geller, N., et al. Advanced seminoma: The role of chemotherapy and adjunctive surgery. Annals of Internal Medicine, 1988, 108, 513–18.Google Scholar
34.Neuhauser, D., & Lewicki, A.What do we gain from the sixth stool guaiac? New England Journal of Medicine, 1975, 293, 226–28.Google Scholar
35.Oliver, R.Long term follow up of single agent cisplatin in metastatic seminoma. Proceedings of American Society of Clinical Oncology, 1988, 7, 463.Google Scholar
36.Penn, C.Single dose and fractionated palliative irradiation for osseous metastases. Clinical Radiology, 1976, 27, 405–58.Google Scholar
37.Price, P., Hoskin, P., Easton, D., et al. A prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases. Radiotherapy and Oncology, 6, 247–55.Google Scholar
38.Priestman, T., Bullimore, J., Godden, T., & Deutsch, F.The Royal College of Radiologists’ fractionation survey. Clinical Oncology, 1989, 1, 39–46.Google Scholar
39.Rees, G.Cost effectiveness in oncology. Lancet, 1985, ii, 1405–28.CrossRefGoogle Scholar
40.Royal College of Radiologists. The next 10 years: Developments in the field of radiotherapy and oncology. Royal College of Radiologists, Report of a Working Party, 1987.Google Scholar
41.Russell, I., Devlin, B., Fell, M., & Glass, N.Day-case surgery for hernias and haemorrhoids. A clinical, social and economic evaluation. Lancet, 1977, i, 844–47.CrossRefGoogle Scholar
42.Scitovsky, A.Changes in the costs of treatment of selected illnesses, 1971–81. Medical Care, 1982, 23, 1345–57.Google Scholar
43.Simpson, J., Francis, M., Perez-Tamayo, R., et al. Palliative radiotherapy for inoperable carcinoma of the lung. Final report of a RTOG multi-institutional trial. International Journal of Radiation: Oncology, Biology, Physics, 1985, 11, 751–58.Google ScholarPubMed
44.Spiro, S., Souhami, R., Geddes, D., et al. Duration of chemotherapy in small cell lung cancer: A cancer research campaign trial. British Journal of Cancer, 1989, 59, 578–83.CrossRefGoogle ScholarPubMed
45.Stoll, B. (ed.). Cost versus benefit in cancer care. London: Macmillan, 1988.CrossRefGoogle Scholar
46.Tattersall, M., & Friedlander, M.Cost considerations in cancer chemotherapy. Australian Health Review, 1982, 5, 21–24.Google Scholar
47.Teeling-Smith, G.Cancer chemotherapy—The price to be paid (editorial). Journal of the Royal Society of Medicine, 1978, 71, 633–35.Google Scholar
48.Tighe, M., & Goodman, S.Carboplatin versus cisplatin. Lancet, 1988, ii, 1372–73.Google Scholar
49.Timothy, A.Report of a conference: Cost versus benefit in non-surgical management of patients with cancer. British Medical Journal, 1988, 297, 471–72.CrossRefGoogle Scholar
50.Tong, D., Gillick, L., & Hendrickson, F.The palliation of symptomatic osseous metastases. Final results of the study by the RTOG. Cancer, 1982, 50, 893–39.Google Scholar
51.Walker, Q., Salkeld, G., Hall, J., et al. The management of oesophageal carcinoma: Radiotherapy or surgery? Cost considerations. European Journal of Cancer and Clinical Oncology, 1989, 25, 1657–62.CrossRefGoogle ScholarPubMed
52.Weissberg, J., Son, Y., Percarpio, B., & Fischer, J.Randomized trial of conventional versus high fractional dose radiation therapy in the treatment of advanced head and neck cancer. International Journal of Radiation: Oncology, Biology, Physics, 1982, 8, 179–85.Google Scholar
53.Wodinsky, H., DeAnglis, C., Rusthoven, J., et al. Re-evaluating the cost of outpatient cancer chemotherapy. Canadian Medical Association Journal, 1987, 137, 903–36.Google Scholar