Sensitivity analysis of cost factors for various therapy options in the treatment of follicular lymphoma.
BACKGROUND
In Germany, patients with relapsed follicular non-Hodgkin's lymphoma do not all receive the same treatment. In this study, 3 therapy regimens were analyzed which were considered to be similar. With the goal of determining the treatment option with the lowest direct costs whilst maintaining the same degree of effectiveness, a cost analysis model was established and applied by way of example to the existing illness constellation.


METHODS
The German doctors' fee scale (Einheitlicher Bewertungsmassstab, EBM) valid until 2005 served as the basis for the calculation of medical services within the scope of the present statutory health insurance guidelines. A virtual standard patient was constructed for the cost model and treated with the different therapy regimens. The incidences of individual adverse events described in literature served as the basis for the characterization of the average toxicity of the respective treatment methods.


RESULTS
The overall costs result from the sum of the treatment costs and the toxicity-related costs. The effect of additional interventions on the overall cost was also examined.


CONCLUSIONS
Whereas the accompanying documentation of costs in clinical studies is organizationally complex and very tedious, the model applied here offers a reliable method of quantifying the costs of the different therapy regimens. It permits the comparison of different treatment alternatives, and it enables, by means of a cost variance analysis, the identification of cost drivers and less expensive measures within a therapy method.
Schmitz
Stephan
S
Hemato-Oncological Group Practice, University Hospital, Sachsenring 69, 50677 Cologne (Köln), Germany. schmitz@oncokoeln.de
Aly
Farid
F
Steinmetz
Tilmann
T
Diehl
Volker
V
Rehwald
Ute
U
D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000191:economics / Q000627:therapeutic use; D004317:Doxorubicin / Q000191:economics / Q000627:therapeutic use; D005062:European Union / Q000191:economics; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008224:Lymphoma, Follicular / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D018803:Models, Economic; D011241:Prednisone / Q000191:economics / Q000627:therapeutic use; D015203:Reproducibility of Results; D000069283:Rituximab; D012680:Sensitivity and Specificity; D014740:Vidarabine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D014750:Vincristine / Q000191:economics / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine; D011241:Prednisone