Shaver Amy L, Tufuor Theresa A, Nie Jing, Ekimura Shauna, Marshall Keri, Mitmesser Susan Hazels, Noyes Katia
Department of Epidemiology and Environmental Health, Division of Health Services Policy and Practice, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA.
Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA.
Cancers (Basel). 2021 Dec 14;13(24):6276. doi: 10.3390/cancers13246276.
Cancer patients are at risk for malnutrition; the aim of this study was to provide a cost-effectiveness analysis of dietary supplementation in cancer survivors. We estimated prevalence of supplementation, hospitalization rates, quality of life (QOL), cost of care and mortality among cancer survivors. We built a decision analytic model to simulate life-long costs of health care and supplementation and QOL among cancer survivors with and without supplementation. Cost of supplements was derived from national pharmacy databases including single- and multivitamin formularies. One-way and probabilistic sensitivity analysis were performed to evaluate the robustness of the incremental cost-effectiveness ratio (ICER) to changes in supplementation costs and duration. The study cohort represented the national cancer survivor population (average age 61 years, 85% white, 52% male, and 94% insured). Hospitalization rates for supplement users and non-users were 12% and 21%, respectively. The cost of hospitalization was $4030. Supplementation was associated with an additional 0.48 QALYs (10.26 vs. 9.78) at the incremental cost of $2094 ($236,933 vs. $234,839) over the remaining lifetime of survivors (on average 13 years). Adequate nutrition provides a cost-effective strategy to achieving potentially optimum health. Further studies are needed to determine the effects of specific nutrient doses and supplementation on long-term outcomes per cancer type.
癌症患者存在营养不良风险；本研究旨在对癌症幸存者膳食补充剂进行成本效益分析。我们估算了癌症幸存者中补充剂的使用 prevalence、住院率、生活质量（QOL）、护理成本及死亡率。我们构建了一个决策分析模型，以模拟有或无补充剂的癌症幸存者终身医疗保健成本、补充剂成本及生活质量。补充剂成本源自包括单一和多种维生素配方的国家药房数据库。进行了单因素和概率敏感性分析，以评估增量成本效益比（ICER）对补充剂成本和持续时间变化的稳健性。研究队列代表全国癌症幸存者人群（平均年龄61岁，85%为白人，52%为男性，94%有保险）。补充剂使用者和非使用者的住院率分别为12%和21%。住院成本为4030美元。在幸存者剩余寿命（平均13年）中，补充剂以2094美元的增量成本（236,933美元对234,839美元）带来了额外的0.48个质量调整生命年（10.26对9.78）。充足的营养是实现潜在最佳健康的一种具有成本效益的策略。需要进一步研究以确定特定营养素剂量和补充剂对每种癌症类型长期结局的影响。
