Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis
Introduction. Breast reconstruction, either immediate or delayed, is part of the treatment of breast cancer. Each country and health system pays for and evaluates these procedures in different ways. Thus, it is important to determine which strategy is most cost-effective in Colombia. Objective: To e...
Published in: | Biomédica |
---|---|
Main Authors: | , |
Format: | Article in Journal/Newspaper |
Language: | English Spanish |
Published: |
Instituto Nacional de Salud
2018
|
Subjects: | |
Online Access: | https://doi.org/10.7705/biomedica.v38i3.3705 https://doaj.org/article/b3788ded4a3d40878a94e3277787b178 |
id |
ftdoajarticles:oai:doaj.org/article:b3788ded4a3d40878a94e3277787b178 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:b3788ded4a3d40878a94e3277787b178 2023-05-15T15:12:09+02:00 Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis Ana Helena Perea Diego Rosselli 2018-09-01T00:00:00Z https://doi.org/10.7705/biomedica.v38i3.3705 https://doaj.org/article/b3788ded4a3d40878a94e3277787b178 EN ES eng spa Instituto Nacional de Salud https://www.revistabiomedica.org/index.php/biomedica/article/view/3705 https://doaj.org/toc/0120-4157 0120-4157 doi:10.7705/biomedica.v38i3.3705 https://doaj.org/article/b3788ded4a3d40878a94e3277787b178 Biomédica: revista del Instituto Nacional de Salud, Vol 38, Iss 3, Pp 363-378 (2018) neoplasias de la mama mastectomía radical modificada mamoplastia análisis costobeneficio calidad de vida Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 article 2018 ftdoajarticles https://doi.org/10.7705/biomedica.v38i3.3705 2022-12-31T01:01:46Z Introduction. Breast reconstruction, either immediate or delayed, is part of the treatment of breast cancer. Each country and health system pays for and evaluates these procedures in different ways. Thus, it is important to determine which strategy is most cost-effective in Colombia. Objective: To evaluate the cost-utility of breast cancer treatment with immediate reconstruction compared with delayed reconstruction. Materials and methods: We used a decision tree model and a one-year time horizon from the perspective of the third-party payer; the cost data were taken from the Colombian Instituto de Seguros Sociales 2001 rate manual plus a 30% adjustment according to the methodology of the Instituto de Evaluación Tecnológica en Salud, IETS, and the billing model of the Centro Javeriano de Oncología at the Hospital Universitario San Ignacio. The transition probabilities and profits were obtained from medical specialists, patients, and the medical literature. We also conducted univariate and probabilistic sensitivity analyses. Results: The expected costs per capita were COP$ 26,710,605 (USD$ 11,165) for the immediate reconstruction and COP$ 26,459,557 (USD$ 11,060) for the deferred reconstruction. Immediate reconstruction generated an incremental cost of COP$ 251,049 (USD$ 105) and 0.75 quality-adjusted life years (QALY), while deferred reconstruction generated 0.63 QALYs, with an incremental cost-utility ratio of COP$ 2,154,675 per QALY (USD$ 901). Conclusions: The cost per QALY did not exceed the acceptability threshold of the Gross Domestic Product (GDP) per capita. The costs for the first year were similar. Both techniques are favorable for the Colombian health system, but the utility reported by patients and the literature is greater with the immediate reconstruction. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Billing ENVELOPE(160.900,160.900,-75.717,-75.717) Biomédica 38 3 363 378 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish |
topic |
neoplasias de la mama mastectomía radical modificada mamoplastia análisis costobeneficio calidad de vida Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
neoplasias de la mama mastectomía radical modificada mamoplastia análisis costobeneficio calidad de vida Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 Ana Helena Perea Diego Rosselli Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
topic_facet |
neoplasias de la mama mastectomía radical modificada mamoplastia análisis costobeneficio calidad de vida Colombia Medicine R Arctic medicine. Tropical medicine RC955-962 |
description |
Introduction. Breast reconstruction, either immediate or delayed, is part of the treatment of breast cancer. Each country and health system pays for and evaluates these procedures in different ways. Thus, it is important to determine which strategy is most cost-effective in Colombia. Objective: To evaluate the cost-utility of breast cancer treatment with immediate reconstruction compared with delayed reconstruction. Materials and methods: We used a decision tree model and a one-year time horizon from the perspective of the third-party payer; the cost data were taken from the Colombian Instituto de Seguros Sociales 2001 rate manual plus a 30% adjustment according to the methodology of the Instituto de Evaluación Tecnológica en Salud, IETS, and the billing model of the Centro Javeriano de Oncología at the Hospital Universitario San Ignacio. The transition probabilities and profits were obtained from medical specialists, patients, and the medical literature. We also conducted univariate and probabilistic sensitivity analyses. Results: The expected costs per capita were COP$ 26,710,605 (USD$ 11,165) for the immediate reconstruction and COP$ 26,459,557 (USD$ 11,060) for the deferred reconstruction. Immediate reconstruction generated an incremental cost of COP$ 251,049 (USD$ 105) and 0.75 quality-adjusted life years (QALY), while deferred reconstruction generated 0.63 QALYs, with an incremental cost-utility ratio of COP$ 2,154,675 per QALY (USD$ 901). Conclusions: The cost per QALY did not exceed the acceptability threshold of the Gross Domestic Product (GDP) per capita. The costs for the first year were similar. Both techniques are favorable for the Colombian health system, but the utility reported by patients and the literature is greater with the immediate reconstruction. |
format |
Article in Journal/Newspaper |
author |
Ana Helena Perea Diego Rosselli |
author_facet |
Ana Helena Perea Diego Rosselli |
author_sort |
Ana Helena Perea |
title |
Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
title_short |
Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
title_full |
Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
title_fullStr |
Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
title_full_unstemmed |
Immediate versus delayed breast reconstruction in breast cancer patients in Colombia: A costutility analysis |
title_sort |
immediate versus delayed breast reconstruction in breast cancer patients in colombia: a costutility analysis |
publisher |
Instituto Nacional de Salud |
publishDate |
2018 |
url |
https://doi.org/10.7705/biomedica.v38i3.3705 https://doaj.org/article/b3788ded4a3d40878a94e3277787b178 |
long_lat |
ENVELOPE(160.900,160.900,-75.717,-75.717) |
geographic |
Arctic Billing |
geographic_facet |
Arctic Billing |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Biomédica: revista del Instituto Nacional de Salud, Vol 38, Iss 3, Pp 363-378 (2018) |
op_relation |
https://www.revistabiomedica.org/index.php/biomedica/article/view/3705 https://doaj.org/toc/0120-4157 0120-4157 doi:10.7705/biomedica.v38i3.3705 https://doaj.org/article/b3788ded4a3d40878a94e3277787b178 |
op_doi |
https://doi.org/10.7705/biomedica.v38i3.3705 |
container_title |
Biomédica |
container_volume |
38 |
container_issue |
3 |
container_start_page |
363 |
op_container_end_page |
378 |
_version_ |
1766342875867512832 |