QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon
Background/purpose: To quantify savings of loss-of-QALE (quality-adjusted life expectancy) and lifetime medical costs from prevention of different cancers. Methods: We collected nation-wide data on 808,700 new cancer cases of 14 different organ systems and followed them from 1998 to 2014 in Taiwan....
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oai:doaj.org-article:6a239035633647c78155a4aeaee5dae12021-12-02T04:59:10ZQALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon0929-664610.1016/j.jfma.2021.04.023https://doaj.org/article/6a239035633647c78155a4aeaee5dae12021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0929664621001807https://doaj.org/toc/0929-6646Background/purpose: To quantify savings of loss-of-QALE (quality-adjusted life expectancy) and lifetime medical costs from prevention of different cancers. Methods: We collected nation-wide data on 808,700 new cancer cases of 14 different organ systems and followed them from 1998 to 2014 in Taiwan. We also collected 13,005 cancer patients from a medical center and 47,320 repeated measurements of quality of life (QoL) of EQ-5D to obtain utility values and multiplied them with the corresponding survival rates to calculate QALE. With Kaplan–Meier estimation to survival function to the end of follow-up, we extrapolated to lifetime through a rolling over algorithm on the logit transform of the survival ratio between the index cohort and age-, sex, and calendar year matched referents simulated from vital statistics. Lifetime costs for each cancer were estimated by multiplying survival with average monthly costs after adjustment with annual discount rate. The loss-of-QALE was estimated by the difference in QALE between the index cancer cohort and corresponding referents. Results: The dynamic changes and weighted averages of the QoL utility values of 14 different cancers ranged from 0.82 to 0.95. Successful prevention of liver, lung, esophagus, or nasopharynx cancer would save more than 10 quality-adjusted life years and more than 21,000 USD per case for both genders. Since the saving of loss-of-QALE was adjusted for different age, sex, and calendar-year distributions, it could be used in cost effectiveness evaluation. Conclusion: Savings of loss-of-QALE and lifetime costs could be used for comparison of prevention, diagnosis, treatment and rehabilitation from a lifetime horizon.Wu-Wei LaiChia-Hua ChungChia-Ni LinSzu-Chun YangJing-Shiang HwangJung-Der WangElsevierarticleQuality-adjusted life expectancyLifetime costUtility valuePreventionMedicine (General)R5-920ENJournal of the Formosan Medical Association, Vol 120, Iss 12, Pp 2089-2099 (2021) |
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Quality-adjusted life expectancy Lifetime cost Utility value Prevention Medicine (General) R5-920 |
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Quality-adjusted life expectancy Lifetime cost Utility value Prevention Medicine (General) R5-920 Wu-Wei Lai Chia-Hua Chung Chia-Ni Lin Szu-Chun Yang Jing-Shiang Hwang Jung-Der Wang QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
description |
Background/purpose: To quantify savings of loss-of-QALE (quality-adjusted life expectancy) and lifetime medical costs from prevention of different cancers. Methods: We collected nation-wide data on 808,700 new cancer cases of 14 different organ systems and followed them from 1998 to 2014 in Taiwan. We also collected 13,005 cancer patients from a medical center and 47,320 repeated measurements of quality of life (QoL) of EQ-5D to obtain utility values and multiplied them with the corresponding survival rates to calculate QALE. With Kaplan–Meier estimation to survival function to the end of follow-up, we extrapolated to lifetime through a rolling over algorithm on the logit transform of the survival ratio between the index cohort and age-, sex, and calendar year matched referents simulated from vital statistics. Lifetime costs for each cancer were estimated by multiplying survival with average monthly costs after adjustment with annual discount rate. The loss-of-QALE was estimated by the difference in QALE between the index cancer cohort and corresponding referents. Results: The dynamic changes and weighted averages of the QoL utility values of 14 different cancers ranged from 0.82 to 0.95. Successful prevention of liver, lung, esophagus, or nasopharynx cancer would save more than 10 quality-adjusted life years and more than 21,000 USD per case for both genders. Since the saving of loss-of-QALE was adjusted for different age, sex, and calendar-year distributions, it could be used in cost effectiveness evaluation. Conclusion: Savings of loss-of-QALE and lifetime costs could be used for comparison of prevention, diagnosis, treatment and rehabilitation from a lifetime horizon. |
format |
article |
author |
Wu-Wei Lai Chia-Hua Chung Chia-Ni Lin Szu-Chun Yang Jing-Shiang Hwang Jung-Der Wang |
author_facet |
Wu-Wei Lai Chia-Hua Chung Chia-Ni Lin Szu-Chun Yang Jing-Shiang Hwang Jung-Der Wang |
author_sort |
Wu-Wei Lai |
title |
QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
title_short |
QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
title_full |
QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
title_fullStr |
QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
title_full_unstemmed |
QALYs and medical costs saved from prevention of a cancer: Analysis of nation-wide real-world data of Taiwan with lifetime horizon |
title_sort |
qalys and medical costs saved from prevention of a cancer: analysis of nation-wide real-world data of taiwan with lifetime horizon |
publisher |
Elsevier |
publishDate |
2021 |
url |
https://doaj.org/article/6a239035633647c78155a4aeaee5dae1 |
work_keys_str_mv |
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