PMID- 19367281
OWN - NLM
STAT- MEDLINE
DCOM- 20090514
LR  - 20211020
IS  - 1532-1827 (Electronic)
IS  - 0007-0920 (Print)
IS  - 0007-0920 (Linking)
VI  - 100
IP  - 8
DP  - 2009 Apr 21
TI  - The impact of healthcare costs in the last year of life and in all life years 
      gained on the cost-effectiveness of cancer screening.
PG  - 1240-4
LID - 10.1038/sj.bjc.6605018 [doi]
AB  - It is under debate whether healthcare costs related to death and in life years 
      gained (LysG) due to life saving interventions should be included in economic 
      evaluations. We estimated the impact of including these costs on 
      cost-effectiveness of cancer screening. We obtained health insurance, home care, 
      nursing homes, and mortality data for 2.1 million inhabitants in the Netherlands 
      in 1998-1999. Costs related to death were approximated by the healthcare costs in 
      the last year of life (LastYL), by cause and age of death. Costs in LYsG were 
      estimated by calculating the healthcare costs in any life year. We calculated the 
      change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the 
      LastYL or in LYsG would be included. Costs in the LastYL were on average 33% 
      higher for persons dying from cancer than from any cause. Including costs in LysG 
      increased the CER by 4040 euro in women, and by 4100 euro in men. Of these, 660 
      euro in women, and 890 euro in men, were costs in the LastYL. Including unrelated 
      healthcare costs in the LastYL or in LYsG will change the comparative 
      cost-effectiveness of healthcare programmes. The CERs of cancer screening 
      programmes will clearly increase, with approximately 4000 euro. However, because 
      of the favourable CER's, including unrelated healthcare costs will in general 
      have limited policy implications.
FAU - de Kok, I M C M
AU  - de Kok IM
AD  - Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 
      Rotterdam, The Netherlands. i.dekok@erasmusmc.nl
FAU - Polder, J J
AU  - Polder JJ
FAU - Habbema, J D F
AU  - Habbema JD
FAU - Berkers, L-M
AU  - Berkers LM
FAU - Meerding, W J
AU  - Meerding WJ
FAU - Rebolj, M
AU  - Rebolj M
FAU - van Ballegooijen, M
AU  - van Ballegooijen M
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Cancer
JT  - British journal of cancer
JID - 0370635
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aging/*physiology
MH  - Child
MH  - Confidence Intervals
MH  - *Cost of Illness
MH  - Cost-Benefit Analysis
MH  - Female
MH  - Humans
MH  - Male
MH  - Mass Screening/*economics
MH  - Middle Aged
MH  - Models, Economic
MH  - Neoplasms/*economics/epidemiology/mortality/prevention & control
MH  - Netherlands
PMC - PMC2676546
EDAT- 2009/04/16 09:00
MHDA- 2009/05/15 09:00
PMCR- 2010/04/21
CRDT- 2009/04/16 09:00
PHST- 2009/04/16 09:00 [entrez]
PHST- 2009/04/16 09:00 [pubmed]
PHST- 2009/05/15 09:00 [medline]
PHST- 2010/04/21 00:00 [pmc-release]
AID - 6605018 [pii]
AID - 10.1038/sj.bjc.6605018 [doi]
PST - ppublish
SO  - Br J Cancer. 2009 Apr 21;100(8):1240-4. doi: 10.1038/sj.bjc.6605018.