Economic cost-utility analysis of stage-directed gastric cancer treatment

Powell, Arfon G. ORCID: https://orcid.org/0000-0002-3740-8275, Wheat, Jennifer R., Eley, Catherine, Robinson, David, Roberts, Stuart A. and Lewis, Wyn 2021. Economic cost-utility analysis of stage-directed gastric cancer treatment. BJS Open 5 (6) , zrab129. 10.1093/bjsopen/zrab129

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Abstract

Background Gastric cancer (GC) treatment levies substantial financial burden on health services. Potentially curative surgery with or without chemotherapy is offered to patients with locoregional disease. This study aimed to examine treatment costs related to life-years gained in patients having potentially curative treatment (gastrectomy) and those receiving best supportive care (BSC). Methods Some 398 consecutive patients with GC were classified according to treatment modality (116 BSC, 282 gastrectomy). Cost calculations for 1 year’s treatment from referral were made according to network diagnostic, staging and treatment algorithms. Primary outcome was overall survival (OS). Results GC median survival after BSC was 8 months, costing €5413, compared with gastrectomy median survival of 34 months, costing €22 753 for 1 year’s treatment: cost per life-year gained €9319. Cost incurred for stage I GC was €22 434, stage II €23 498, stage III €22 445, and stage IV €22 032. Based on these values, the cost per quality adjusted life-year (QALY) for BSC for stage I GC was –€8335 stage II –€8952, stage III –€11 317, and stage IV –€25 669. Conclusion Potentially curative treatment that included gastrectomy improved OS four-fold compared with BSC and was cost-effective at national thresholds of readiness to pay per QALY.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/)
Publisher:	Oxford University Press
ISSN:	2474-9842
Date of First Compliant Deposit:	14 February 2022
Date of Acceptance:	14 October 2021
Last Modified:	24 May 2023 17:05
URI:	https://orca.cardiff.ac.uk/id/eprint/147423

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