Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China
Abstract Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients’ quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early bre...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-021-07840-6 |
| _version_ | 1818459710105321472 |
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| author | Qing Yang Xiaorong Zhong Wei Zhang Ting Luo Ping He Hong Zheng |
| author_facet | Qing Yang Xiaorong Zhong Wei Zhang Ting Luo Ping He Hong Zheng |
| author_sort | Qing Yang |
| collection | DOAJ |
| description | Abstract Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients’ quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON). Methods Based on demographic data, disease-related information and other treatments, we applied propensity score matching (PSM) to perform 1: 1 matching among patients who underwent these three types of surgery in the tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Results After PSM, there were 205 cases in each group. In the matched data set, the distribution of covariates was fully balanced. The total cost of MAST, MAST+RECON and BCT was $37,392.84, $70,556.03 and $82,330.97, respectively. The quality-adjusted life year (QALYs) were 17.11, 18.40 and 20.20, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $25,707.90/QALY and $14,543.08/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis. Conclusions We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution. |
| first_indexed | 2024-12-14T23:18:40Z |
| format | Article |
| id | doaj.art-b186f151d74a431493fce6c042968d1b |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-14T23:18:40Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-b186f151d74a431493fce6c042968d1b2022-12-21T22:44:02ZengBMCBMC Cancer1471-24072021-02-0121111210.1186/s12885-021-07840-6Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from ChinaQing Yang0Xiaorong Zhong1Wei Zhang2Ting Luo3Ping He4Hong Zheng5Institute of Hospital Management, West China Hospital, Sichuan UniversityDepartment of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan UniversityWest China Biomedical Big Data Center, West China Hospital, Sichuan UniversityDepartment of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan UniversityDepartment of Head, Neck and Mammary Gland Oncology, Cancer Center, West China Hospital, Sichuan UniversityAbstract Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients’ quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON). Methods Based on demographic data, disease-related information and other treatments, we applied propensity score matching (PSM) to perform 1: 1 matching among patients who underwent these three types of surgery in the tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Results After PSM, there were 205 cases in each group. In the matched data set, the distribution of covariates was fully balanced. The total cost of MAST, MAST+RECON and BCT was $37,392.84, $70,556.03 and $82,330.97, respectively. The quality-adjusted life year (QALYs) were 17.11, 18.40 and 20.20, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $25,707.90/QALY and $14,543.08/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis. Conclusions We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.https://doi.org/10.1186/s12885-021-07840-6Breast cancerCost-effectivenessMastectomyBreast-conserving therapyBreast reconstruction |
| spellingShingle | Qing Yang Xiaorong Zhong Wei Zhang Ting Luo Ping He Hong Zheng Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China BMC Cancer Breast cancer Cost-effectiveness Mastectomy Breast-conserving therapy Breast reconstruction |
| title | Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China |
| title_full | Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China |
| title_fullStr | Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China |
| title_full_unstemmed | Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China |
| title_short | Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China |
| title_sort | cost effectiveness of different surgical treatment approaches for early breast cancer a retrospective matched cohort study from china |
| topic | Breast cancer Cost-effectiveness Mastectomy Breast-conserving therapy Breast reconstruction |
| url | https://doi.org/10.1186/s12885-021-07840-6 |
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