Dataset Information

The cost of failed first-line cancer treatment related to continued smoking in Canada.

ABSTRACT:

Background

Smoking by cancer patients and survivors causes adverse cancer treatment outcomes, but little information is available about how smoking can affect cancer treatment costs.

Methods

We developed a model to estimate attributable cancer treatment failure because of continued smoking after a cancer diagnosis (af_s). Canadian health system data were used to determine the additional treatment cost for af_s for the most common cancers in Canada.

Results

Of 206,000 patients diagnosed with cancer annually, an estimated 4789 experienced af_s. The annual incremental cost associated with treating patients experiencing af_s was estimated at between $198 million and $295 million (2017 Canadian dollars), reflecting an added incremental cost of $4,810-$7,162 per patient who continued to smoke. Analyses according to disease site demonstrated higher incremental costs where the smoking prevalence and the cost of individual second-line cancer treatment were highest. Of breast, prostate, colorectal, and lung cancers, lung cancer was associated with the highest incremental cost for treatment after af_s.

Conclusions

The costs associated with af_s in Canada after a cancer diagnosis are considerable. Populations in which the smoking prevalence and treatment costs are high are expected to benefit the most from efforts aimed at increasing smoking cessation capacity for patients newly diagnosed with cancer.

SUBMITTER: Iragorri N

PROVIDER: S-EPMC7755446 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

The cost of failed first-line cancer treatment related to continued smoking in Canada.

Iragorri N N Essue B B Timmings C C Keen D D Bryant H H Warren G W GW

Current oncology (Toronto, Ont.) 20201201 6

<h4>Background</h4>Smoking by cancer patients and survivors causes adverse cancer treatment outcomes, but little information is available about how smoking can affect cancer treatment costs.<h4>Methods</h4>We developed a model to estimate attributable cancer treatment failure because of continued smoking after a cancer diagnosis (af<sub>s</sub>). Canadian health system data were used to determine the additional treatment cost for af<sub>s</sub> for the most common cancers in Canada.<h4>Results</ ...[more]

PMID: 33380862

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Project description:ImportancePrevious studies have shown that continued smoking among patients with cancer can increase overall and cancer-specific mortality, risk for second primary cancer, and risk for toxic effects of cancer treatment. To our knowledge, there have been no efforts to estimate additional costs for cancer treatment attributed to smoking.ObjectiveTo model attributable incremental costs of subsequent cancer treatment associated with continued smoking by patients with cancer.Design, setting, and participantsFor this economic evaluation, a model was developed in 2018 using data from a 2014 US Surgeon General's report that considered expected failure rates of first-line cancer treatment in nonsmoking patients, smoking prevalence, odds ratio of first-line cancer treatment failure attributed to smoking compared with nonsmoking, and cost of cancer treatment after failure of first-line cancer treatment.Main outcomes and measuresAttributable failures of first-line cancer treatment and incremental cost for subsequent treatment associated with continued smoking among patients with cancer.ResultsAttributable treatment failures were higher under conditions in which high first-line cure rates were expected in nonsmoking patients compared with conditions in which low cure rates were expected. Peak attributable failures occurred under the conditions in which expected cure rates among nonsmoking patients ranged from 50% to 65%. Under the conditions of a 30% expected treatment failure rate among nonsmoking patients, 20% smoking prevalence, 60% increased risk of failure of first-line cancer treatment, and $100 000 mean added cost of treating a first-line cancer treatment failure, the additional incremental cost per 1000 total patients was estimated to be $2.1 million, reflecting an additional cost of $10 678 per smoking patient. Extrapolation of cost to 1.6 million patients with cancer diagnosed annually reflects a potential $3.4 billion in incremental cost.Conclusions and relevanceThe findings suggest that continued smoking among patients with cancer and the increase in attributable first-line cancer treatment failure is associated with significant incremental costs for subsequent cancer treatments. Additional work appears to be needed to identify optimal methods to mitigate these incremental costs.

Project description:BackgroundCurrently, in Belgium, bevacizumab is reimbursed for ovarian cancer patients, based on a contract between the Minister and the manufacturer including confidential agreements. This reimbursement will be re-evaluated in 2018.ObjectiveTo support the reimbursement reassessment by calculating the cost-effectiveness of bevacizumab: (1) in addition to first-line chemotherapy; (2) in the treatment of recurrent ovarian cancer (platinum-sensitive or platinum-resistant).MethodsA health economic model has been developed for the Belgian situation according to the Belgian guidelines for economic evaluations. The lifetime Markov model was set up from the perspective of the health care payer (government and patient), including direct healthcare related costs. Results are expressed as the extra costs per quality-adjusted life year (QALY). Calculations were based on results of four international trials. Both probabilistic and one-way sensitivity analyses were performed.ResultsIncremental cost-effectiveness ratios (ICERs) of first-line bevacizumab are on average 158 000/QALY (GOG-0218 trial) and 443 000/QALY (ICON7 trial). The most favourable scenario is based on the stage IV subgroup of the GOG-0218 trial (€52 000/QALY). Since subgroup findings are often exploratory and require confirmatory studies, results of the economic evaluation based on this subgroup analysis should be considered with caution. For second-line bevacizumab, ICERs are on average €587 000/QALY (OCEANS trial) and €172 000/QALY (AURELIA trial). Sensitivity analysis shows that results are most sensitive to the price of bevacizumab.ConclusionFrom a health economic perspective, ICERs of bevacizumab are relatively high. The most favourable results are found for first-line treatment of stage IV ovarian cancer patients. Price reductions have a major impact on the estimated ICERs. It is recommended to take these findings into account when re-evaluating the reimbursement of bevacizumab in ovarian cancer.

Dataset Information

The cost of failed first-line cancer treatment related to continued smoking in Canada.

Background

Methods

Results

Conclusions

Publications

The cost of failed first-line cancer treatment related to continued smoking in Canada.

Similar Datasets

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