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A cost-utility analysis of a rehabilitation service for people living with and beyond cancer
BACKGROUND: We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data. METHODS: Forty-one participants were...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245741/ https://www.ncbi.nlm.nih.gov/pubmed/25407558 http://dx.doi.org/10.1186/s12913-014-0558-5 |
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author | Round, Jeff Leurent, Baptiste Jones, Louise |
author_facet | Round, Jeff Leurent, Baptiste Jones, Louise |
author_sort | Round, Jeff |
collection | PubMed |
description | BACKGROUND: We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data. METHODS: Forty-one participants were recruited into the study. A within-trial stochastic cost-utility analysis was undertaken using Monte-Carlo simulation. The outcome measure for the economic evaluation was quality adjusted life years (QALYs). Costs were measured from the perspective of the NHS and personal social services. Uncertainty in the observed data was captured through probabilistic sensitivity analysis. Scenario analysis was conducted to explore the effects of changing the way QALYs were estimated and adjusting for baseline difference in the population. We also explore assumptions about the length of treatment benefit being maintained. RESULTS: The incremental cost-effectiveness ratio (ICER) for the base-case analysis was £14,231 per QALY. When QALYs were assumed to change linearly over time, this increased to £20,514 per QALY at three months. Adjusting the estimate of QALYs to account for differences in the population at baseline increased the ICER to £94,748 per QALY at three months. Increasing the assumed length of treatment benefit led to reduced ICERs in all scenarios. CONCLUSIONS: Although the intervention is likely to be cost-effective in some circumstances, there is considerable uncertainty surrounding the decision to implement the service. Further research, informed by a formal value of information analysis, would reduce this uncertainty. |
format | Online Article Text |
id | pubmed-4245741 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42457412014-11-28 A cost-utility analysis of a rehabilitation service for people living with and beyond cancer Round, Jeff Leurent, Baptiste Jones, Louise BMC Health Serv Res Research Article BACKGROUND: We conducted a wait-list control randomised trial of an outpatient rehabilitation service for people living with and beyond cancer, delivered in a hospice day care unit. We report the results of an economic evaluation undertaken using the trial data. METHODS: Forty-one participants were recruited into the study. A within-trial stochastic cost-utility analysis was undertaken using Monte-Carlo simulation. The outcome measure for the economic evaluation was quality adjusted life years (QALYs). Costs were measured from the perspective of the NHS and personal social services. Uncertainty in the observed data was captured through probabilistic sensitivity analysis. Scenario analysis was conducted to explore the effects of changing the way QALYs were estimated and adjusting for baseline difference in the population. We also explore assumptions about the length of treatment benefit being maintained. RESULTS: The incremental cost-effectiveness ratio (ICER) for the base-case analysis was £14,231 per QALY. When QALYs were assumed to change linearly over time, this increased to £20,514 per QALY at three months. Adjusting the estimate of QALYs to account for differences in the population at baseline increased the ICER to £94,748 per QALY at three months. Increasing the assumed length of treatment benefit led to reduced ICERs in all scenarios. CONCLUSIONS: Although the intervention is likely to be cost-effective in some circumstances, there is considerable uncertainty surrounding the decision to implement the service. Further research, informed by a formal value of information analysis, would reduce this uncertainty. BioMed Central 2014-11-19 /pmc/articles/PMC4245741/ /pubmed/25407558 http://dx.doi.org/10.1186/s12913-014-0558-5 Text en © Round et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Round, Jeff Leurent, Baptiste Jones, Louise A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title | A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title_full | A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title_fullStr | A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title_full_unstemmed | A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title_short | A cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
title_sort | cost-utility analysis of a rehabilitation service for people living with and beyond cancer |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245741/ https://www.ncbi.nlm.nih.gov/pubmed/25407558 http://dx.doi.org/10.1186/s12913-014-0558-5 |
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