The cost of chemotherapy administration: a systematic review and meta-analysis.


Journal

The European journal of health economics : HEPAC : health economics in prevention and care
ISSN: 1618-7601
Titre abrégé: Eur J Health Econ
Pays: Germany
ID NLM: 101134867

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 05 04 2020
accepted: 25 02 2021
pubmed: 10 3 2021
medline: 18 9 2021
entrez: 9 3 2021
Statut: ppublish

Résumé

Cancer treatment is a significant driver of healthcare costs worldwide, however, the economic impact of treating patients with anti-neoplastic agents is poorly elucidated. We conducted a systematic review and meta-analysis to estimate the direct costs associated with administering intravenous chemotherapy in an outpatient setting. We systematically searched four databases from 2010 to present and extracted hourly administration costs and the respective components of each estimate. Separate analyses were conducted of Canadian and United States (US) studies, respectively, to address a priori hypotheses regarding heterogeneity amongst estimates. The Drummond checklist was used to assess risk-of-bias. Data were summarized using medians with interquartile ranges and five outliers were identified; costs were presented in 2019 USD. Forty-four studies were analyzed, including sub-analyses of 19 US and seven Canadian studies. 26/44 studies were of moderate-high quality. When components of administration cost were evaluated, physician costs were reported most frequently (24 studies), followed by lab tests (13) and overhead costs (9). The median estimate (excluding outliers) was $142/hour (IQR = $103-166). The median administration cost in the US was $149/hour (IQR = $118-158), and was $128/hour (IQR = $102-137) in Canada. There is currently a paucity of literature addressing the costs of chemotherapy administration, and existing studies utilize a patchwork of reporting methodologies which renders direct comparison challenging. Our results demonstrate that the cost of administering chemotherapy is approximately $125-150/hour, globally. This value is dependent upon the region of analysis, inclusiveness of cost subcomponents as well as the methodology used to estimate unit prices, as described here.

Identifiants

pubmed: 33687618
doi: 10.1007/s10198-021-01278-0
pii: 10.1007/s10198-021-01278-0
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

605-620

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Auteurs

Gursharan K Sohi (GK)

Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.

Jordan Levy (J)

Division of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room T2 011, Toronto, ON, M4N 3M5, Canada.

Victoria Delibasic (V)

Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.

Laura E Davis (LE)

Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.

Alyson L Mahar (AL)

Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Elmira Amirazodi (E)

Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.

Craig C Earle (CC)

Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Julie Hallet (J)

Division of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room T2 011, Toronto, ON, M4N 3M5, Canada.

Ahmed Hammad (A)

ICES, Toronto, ON, Canada.

Rajan Shah (R)

Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.

Nicole Mittmann (N)

Division of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Natalie G Coburn (NG)

Division of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room T2 011, Toronto, ON, M4N 3M5, Canada. natalie.coburn@sunnybrook.ca.

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