Puspitasari Irma M, Legianawati Dewi, Sinuraya Rano K, Suwantika Auliya A
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia.
Int J Womens Health. 2021 Feb 19;13:221-229. doi: 10.2147/IJWH.S289781. eCollection 2021.
Cervical cancer is the second most common type of cancer and cause of death from cancer in Indonesia. In 2013, cervical cancer was the most prevalent cancer in Indonesia, with a rate of 0.8 per 1000 women. Based on the National Guidelines for Cervical Cancer Medical Services in Indonesia, the recommended therapy for stages IIB-IIIB cervical cancer is chemoradiation or radiotherapy. This study aimed to evaluate the cost-effectiveness of chemoradiation and radiotherapy for treating stage IIB-IIIB cervical cancer in a national referral hospital in Indonesia.
A cross-sectional study from a healthcare perspective using retrospective patient data was conducted. The included patients had stage IIB-IIIB registered cervical cancer, were in the hospital between January 1, 2015 and December 31, 2017, received chemoradiation or radiotherapy, were ≥18 years old, and had complete clinical data and detailed cost of therapy data. The incremental cost-effectiveness ratio (ICER) were calculated, and a sensitivity analysis was performed.
The average treatment cost per patient was $2944 and $3231 for radiotherapy and chemoradiation, respectively. Despite the fact that the treatment effectiveness of chemoradiation (69.1%) was considered to be higher than that of radiotherapy (63.2%), chemoradiation had more potential side effects than radiotherapy. In a comparison with radiotherapy, the ICER of chemoradiation was $48.6 per complete response rate. Additionally, the cost of radiotherapy was the most influential parameter impacting the ICER.
Chemoradiation was considered to be more costly than radiotherapy. Additionally, the effectiveness of chemoradiation was higher than that of radiotherapy. A cost utility analysis (CUA) is required for further investigation.
宫颈癌是印度尼西亚第二常见的癌症类型及癌症死亡原因。2013年，宫颈癌是印度尼西亚最普遍的癌症，发病率为每1000名女性中有0.8例。根据印度尼西亚宫颈癌医疗服务国家指南，IIB-IIIB期宫颈癌的推荐治疗方法是放化疗或放射治疗。本研究旨在评估在印度尼西亚一家国家转诊医院中，放化疗和放射治疗IIB-IIIB期宫颈癌的成本效益。
从医疗保健角度进行一项横断面研究，使用回顾性患者数据。纳入的患者患有登记为IIB-IIIB期的宫颈癌，于2015年1月1日至2017年12月31日期间住院，接受了放化疗或放射治疗，年龄≥18岁，并有完整的临床数据和详细的治疗费用数据。计算增量成本效益比（ICER），并进行敏感性分析。
放射治疗和放化疗的每位患者平均治疗成本分别为2944美元和3231美元。尽管放化疗的治疗效果（69.1%）被认为高于放射治疗（63.2%），但放化疗比放射治疗有更多潜在副作用。与放射治疗相比，放化疗的ICER为每完全缓解率成本48.6美元。此外，放射治疗成本是影响ICER的最具影响力参数。
放化疗被认为比放射治疗成本更高。此外，放化疗的效果高于放射治疗。需要进行成本效用分析（CUA）以作进一步调查。
