The presence of bone metastases is a common event in the natural history of nearly all neoplasms which often affects the patient’s quality of life. The widespread extent of bone disease in cancer patients justifies the development of targeted therapy for the treatment of cancer and for pain relief in particular. Therapeutic nuclear medicine is rapidly developing as an additional treatment strategy in oncology. The present study aims at assessing costs and resource utilisation patterns of patients suffering from prostate cancer treated with the radionuclide therapy against the conventional pain therapy in the Italian context. Total incremental costs within the national health care system and payer’s incremental costs are taken into consideration. The first step of our survey consists in a literature review about the use of the radionuclide therapy in the Italian context in the last 5 years. It demonstrated that this field lacks of data as to resource utilisation, while effectiveness assessments (available in clinical trials) have been broadly conducted. Because of the lack of information concerning resource utilizations, experts opinion have been gathered through the ‘modified Delphi method’. From the cost-effectiveness analysis it emerges that radionuclide therapy with samarium is cost effective. Total direct costs over a four months period of conventional pain therapy amounts to 717,84 euros compared to 1.380,06 euros under samarium. Complete pain response, as given by the clinical trial, is 18 % under conventional pain therapy and 38 % under samarium therapy. Hence, the average costs per complete pain responder under conventional pain therapy are 3.988,00 euros and 3.631,74 euros under samarium therapy. The incremental cost effectiveness ratio (ICER) is 3.311,11 euros per additional complete pain responder.
Analisi costi-efficacia della cura del dolore in Italia: la radioisotopoterapia con Samario-153 e la terapia convenzionale
OTTO, MONICA HILDEGARD;TARRICONE, ROSANNA
2004
Abstract
The presence of bone metastases is a common event in the natural history of nearly all neoplasms which often affects the patient’s quality of life. The widespread extent of bone disease in cancer patients justifies the development of targeted therapy for the treatment of cancer and for pain relief in particular. Therapeutic nuclear medicine is rapidly developing as an additional treatment strategy in oncology. The present study aims at assessing costs and resource utilisation patterns of patients suffering from prostate cancer treated with the radionuclide therapy against the conventional pain therapy in the Italian context. Total incremental costs within the national health care system and payer’s incremental costs are taken into consideration. The first step of our survey consists in a literature review about the use of the radionuclide therapy in the Italian context in the last 5 years. It demonstrated that this field lacks of data as to resource utilisation, while effectiveness assessments (available in clinical trials) have been broadly conducted. Because of the lack of information concerning resource utilizations, experts opinion have been gathered through the ‘modified Delphi method’. From the cost-effectiveness analysis it emerges that radionuclide therapy with samarium is cost effective. Total direct costs over a four months period of conventional pain therapy amounts to 717,84 euros compared to 1.380,06 euros under samarium. Complete pain response, as given by the clinical trial, is 18 % under conventional pain therapy and 38 % under samarium therapy. Hence, the average costs per complete pain responder under conventional pain therapy are 3.988,00 euros and 3.631,74 euros under samarium therapy. The incremental cost effectiveness ratio (ICER) is 3.311,11 euros per additional complete pain responder.
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