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采用基于回顾性图表审查的德尔菲小组,研究中、东欧卵巢癌的治疗模式、医疗保健利用情况和成本。

Treatment patterns, health care utilization, and costs of ovarian cancer in Central and Eastern Europe using a Delphi panel based on a retrospective chart review.

机构信息

OptumInsight, Stockholm, Sweden.

出版信息

Int J Gynecol Cancer. 2013 Jun;23(5):823-32. doi: 10.1097/IGC.0b013e318291e8ca.

Abstract

OBJECTIVE

Despite the considerable disease burden of ovarian cancer, there were no cost studies in Central and Eastern Europe. This study aimed to describe treatment patterns, health care utilization, and costs associated with treating ovarian cancer in Hungary, Poland, Serbia, and Slovakia.

METHOD

Overall clinical practice for management of epithelial ovarian cancer was investigated through a 3-round Delphi panel. Experts completed a survey based on the chart review (n = 1542). The survey was developed based on clinical guidelines and the International Federation of Gynecology and Obstetrics Annual Report. Means, ranges, and outlier values were discussed with the experts during a telephone interview. Finally, consensus estimates were obtained in face-to-face workshops. Based on these results, overall cost of ovarian cancer was estimated using a Markov model.

RESULTS

The patients included in the chart review were followed up from presurgical diagnosis and in each phase of treatment, that is, surgical staging and primary surgery, chemotherapy and chemotherapy monitoring, follow-up, and palliative care. The 5-year overall cost per patient was €14,100 to €16,300 in Hungary, €14,600 to €15,800 in Poland, €7600 to €8100 in Serbia, and €12,400 to €14,500 in Slovakia. The main components were chemotherapy-associated costs (68%-74% of the total cost), followed by cost of primary treatment with surgery (15%-21%) and palliative care (3%-10%).

CONCLUSIONS

Patients with ovarian cancer consume considerable health care resources and incur substantial costs in Central and Eastern Europe. These findings may prove useful for clinicians and decision makers in understanding the economic implications of managing ovarian cancer in Central and Eastern Europe and the need for innovative therapies.

摘要

目的

尽管卵巢癌患者的疾病负担相当大,但在中东欧地区尚无成本研究。本研究旨在描述匈牙利、波兰、塞尔维亚和斯洛伐克治疗卵巢癌的治疗模式、卫生保健利用情况和相关成本。

方法

通过三轮德尔菲小组调查,全面研究上皮性卵巢癌的整体临床实践。专家根据病历回顾(n=1542)完成了一项调查。该调查是基于临床指南和国际妇产科联合会年度报告制定的。在电话访谈中,与专家讨论了平均值、范围和异常值。最后,在面对面的研讨会上获得了共识估计值。基于这些结果,使用马尔可夫模型估计了卵巢癌的总体成本。

结果

病历回顾中纳入的患者从术前诊断开始,在治疗的每个阶段都进行了随访,即手术分期和初次手术、化疗和化疗监测、随访和姑息治疗。匈牙利每位患者的 5 年总费用为 14100 至 16300 欧元,波兰为 14600 至 15800 欧元,塞尔维亚为 7600 至 8100 欧元,斯洛伐克为 12400 至 14500 欧元。主要组成部分是与化疗相关的成本(占总成本的 68%-74%),其次是手术为主的初次治疗费用(15%-21%)和姑息治疗费用(3%-10%)。

结论

中东欧地区的卵巢癌患者消耗了大量的医疗资源,并产生了大量的费用。这些发现可能有助于临床医生和决策者了解在中东欧地区管理卵巢癌的经济影响以及对创新疗法的需求。

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