Back to Search
Start Over
Cost-effectiveness analysis of hospital treatment volume and survival outcomes in endometrial cancer in Japan.
- Source :
-
Journal of gynecologic oncology [J Gynecol Oncol] 2024 Sep; Vol. 35 (5), pp. e61. Date of Electronic Publication: 2024 Feb 26. - Publication Year :
- 2024
-
Abstract
- Objective: Hospital treatment volume affects survival in patients with endometrial cancer; notably, initial treatment at high-volume centers improves survival outcomes. Our study assessed the effect of hospital treatment volume on cost-effectiveness and survival outcomes in patients with endometrial cancer in Japan.<br />Methods: A decision-analytic model was evaluated using the following variables and their impact on cost-effectiveness: 1) hospital treatment volume (low-, intermediate-, and high-volume centers) and 2) postoperative recurrent risk factors based on pathological findings (high- and intermediate-risk or low-risk). Data were obtained from the Japan Society of Obstetrics and Gynecology database, systematic literature searches, and the Japanese Diagnosis Procedure Combination database. Quality-adjusted life years (QALY) was used as a measure of effectiveness. The model was built from a public healthcare perspective and the impact of uncertainty was assessed using sensitivity analyses.<br />Results: A base-case analysis showed that the incremental cost-effectiveness ratio at high-volume centers was below a willingness-to-pay (WTP) threshold of ¥5,000,000 with a maximum of ¥3,777,830/4.28 QALY for the high- and intermediate-risk group, and ¥2,316,695/4.57 QALY for the low-risk group. Treatment at the high-volume centers showed better efficiency and cost-effectiveness in both strategies compared to intermediate- or low-volume centers. Sensitivity analyses showed that the model outcome was robust to changes in input values. With the WTP threshold, treatment at high-volume centers remained cost-effective in at least 73.6% and 78.2% of iterations for high- and intermediate-risk, and low-risk groups, respectively.<br />Conclusion: Treatment at high-volume centers is the most cost-effective strategy for guiding treatment centralization in patients with endometrial cancer.<br />Competing Interests: Honorarium, Bristol Myers Squibb (H.M) and none for others.<br /> (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
- Subjects :
- Humans
Female
Japan
Hospitals, Low-Volume statistics & numerical data
Hospitals, Low-Volume economics
Decision Support Techniques
Middle Aged
Aged
Cost-Effectiveness Analysis
Endometrial Neoplasms economics
Endometrial Neoplasms therapy
Endometrial Neoplasms mortality
Endometrial Neoplasms pathology
Cost-Benefit Analysis
Hospitals, High-Volume statistics & numerical data
Quality-Adjusted Life Years
Subjects
Details
- Language :
- English
- ISSN :
- 2005-0399
- Volume :
- 35
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38456587
- Full Text :
- https://doi.org/10.3802/jgo.2024.35.e61