Document Type : Research Articles
Authors
1
Department of Health Service Administration, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
2
Department of Radiation Oncology, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
3
Student Research Committee, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
4
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
5
Department of Community Medicine, Shiraz Nephro – Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.
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