Cost-effectiveness of intensive Vs. standard follow-up models for patients with breast cancer in Shiraz, Iran

Hatam, N. and Ahmadloo, N. and Vazirzadeh, M. and Jafari, A. and Askarian, M. (2016) Cost-effectiveness of intensive Vs. standard follow-up models for patients with breast cancer in Shiraz, Iran. Asian Pacific Journal of Cancer Prevention, 17 (12). pp. 6209-6214.

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Abstract

Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US24,494.62 and US6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.

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