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White BE, Mujica-Mota R, Snowsill T, Gamper EM, Srirajaskanthan R, Ramage JK. Evaluating cost-effectiveness in the management of neuroendocrine neoplasms. Rev Endocr Metab Disord 2021; 22:647-663. [PMID: 33155118 PMCID: PMC8346405 DOI: 10.1007/s11154-020-09608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2020] [Indexed: 10/27/2022]
Abstract
The rapid evolution of novel, costly therapies for neuroendocrine neoplasia (NEN) warrants formal high-quality cost-effectiveness evaluation. Costs of individual investigations and therapies are high; and examples are presented. We aimed to review the last ten years of standalone health economic evaluations in NEN. Comparing to published standards, EMBASE, Cochrane library, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database and the Health Technology Assessment (HTA) Database were searched for health economic evaluations (HEEs) in NEN published between 2010 and October 2019. Of 12 economic evaluations, 11 considered exclusively pharmacological treatment (3 studies of SSAs, 7 studies of sunitinib, everolimus and/or 177Lu-DOTATATE and 1 study of telotristat ethyl) and 1 compared surgery with intraarterial therapy. 7 studies of pharmacological treatment had placebo or best supportive care as the only comparator. There remains a paucity of economic evaluations in NEN with the majority industry funded. Most HEEs reviewed did not meet published health economic criteria used to assess quality. Lack of cost data collected from patient populations remains a significant factor in HEEs where clinical expert opinion is still often substituted. Further research utilizing high-quality effectiveness data and rigorous applied health economic analysis is needed.
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Affiliation(s)
- B E White
- Department of Gastroenterology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Hampshire, UK
- Kings Health Partners Neuroendocrine Tumour Centre of Excellence, London, UK
| | - R Mujica-Mota
- Department of Health Economics, University of Leeds, Leeds, UK
| | - T Snowsill
- Department of Health Economics, University of Exeter, Exeter, UK
| | - E M Gamper
- Innsbruck Institute of Patient-centered Outcome Research (IIPCOR), Innsbruck, Austria
| | - R Srirajaskanthan
- Kings Health Partners Neuroendocrine Tumour Centre of Excellence, London, UK
| | - J K Ramage
- Department of Gastroenterology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Hampshire, UK.
- Kings Health Partners Neuroendocrine Tumour Centre of Excellence, London, UK.
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Wintner LM, Giesinger JM, Zabernigg A, Rumpold G, Sztankay M, Oberguggenberger AS, Gamper EM, Holzner B. Evaluation of electronic patient-reported outcome assessment with cancer patients in the hospital and at home. BMC Med Inform Decis Mak 2015; 15:110. [PMID: 26699708 PMCID: PMC4690412 DOI: 10.1186/s12911-015-0230-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reported outcomes (PRO) provide a more comprehensive picture of patients' quality of life than do mere physicians' ratings. Electronic data collection of PRO offers several advantages and allows assessments at patients' homes as well. This study reports on patients' personal internet use, their attitudes towards electronic and web-based PRO assessment (clinic-ePRO and home-ePRO) and the feasibility of these two assessment modes. METHODS At the Medical University of Innsbruck and Kufstein County Hospital, cancer patients who participated in clinic-ePRO/home-ePRO were asked to complete a comprehensive evaluation form on their personal internet usage, attitudes towards and the feasibility of routine clinic-ePRO/home-ePRO with the Computer-based Health Evaluation System (CHES) software. RESULTS In total, 113 patients completed the evaluation form for clinic-ePRO (Ø 45 years, SD 14) and 45 patients for home-ePRO (Ø 58 years, SD 10; 33.1 per cent inclusion rate for this sample). Most patients expressed willingness to complete routine clinic-ePRO assessments in the future (94.7 per cent of clinic-ePRO patients and 84.4 per cent of home-ePRO patients) and to discuss their data with attending physicians (82.2 per cent, home-ePRO patients only). Overall, patients preferred the software over paper-pencil questionnaires (67.2 per cent of clinic-ePRO patients and 60 per cent of home-ePRO patients) and experienced it as easy to use. Only a few minor suggestions for improvement were made (e.g. adjustable font sizes). CONCLUSIONS The use of clinic-ePRO/home-ePRO was in general shown to be feasible and well accepted. However, to be more inclusive in the implementation of clinic-ePRO/home-ePRO, educational programs concerning their particular benefit in oncology practice potentially could enhance patients' attitudes towards, and consequently their acceptance of and compliance with electronic PRO assessments.
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Affiliation(s)
- L M Wintner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria. .,Leopold-Franzens-University of Innsbruck, Innrain 52, Innsbruck, 6020, Austria.
| | - J M Giesinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria
| | - A Zabernigg
- Department of Internal Medicine Kufstein County Hospital, Endach 27, Kufstein, 6330, Austria
| | - G Rumpold
- Department of Medical Psychology, Medical University of Innsbruck, Schöpfstraße 23a, Innsbruck, 6020, Austria
| | - M Sztankay
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria.,Leopold-Franzens-University of Innsbruck, Innrain 52, Innsbruck, 6020, Austria
| | - A S Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria
| | - E M Gamper
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Anichstr.35, Innsbruck, 6020, Austria
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Berger A, Oberguggenberger A, Sztankay M, Meraner V, Beer B, Oberacher H, Giesinger J, Kemmler G, Egle D, Gamper EM, Sperner-Unterweger B, Holzner B, Marth C, Hubalek M. Wird die Toxizität einer adjuvanten Therapie mit Aromataseinhibitoren unterschätzt? Zusätzliche Informationen durch Patientinnen Feedback Fragebögen. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1336792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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