title: A review of cost-effectiveness studies in ovarian cancer.
abstract: BACKGROUND
  Ovarian cancer is the fifth leading cause of all cancer-related deaths among women. While the costs of diagnosis and treatment impact the affected individual and the health system, the most important costs for the patient are often the pain and suffering associated with ovarian cancer. The quality of life associated with any management decision should be closely examined. Cost-effectiveness models take into account costs, effects, and quality of life and provide clinicians with useful tools to aid in making these difficult decisions.
  
  
  METHODS
  A comprehensive review of cost-effectiveness analyses was undertaken concerning screening for and treatment of ovarian cancer.
  
  
  RESULTS
  Screening methods to detect ovarian cancer are unproven, and the majority of women present with advanced-stage disease. Multimodal screening strategies with high specificities targeted at the highest-risk individuals are the most likely strategies to be cost-effective. Primary treatment with intravenous paclitaxel and platinum regimens has proven to be cost-effective in multiple studies. Studies evaluating intraperitoneal chemotherapy show that this strategy is potentially cost-effective over a long-term time horizon. A cost-effectiveness analysis of the management of recurrent platinum-sensitive ovarian cancer showed that treatment with carboplatin and paclitaxel is cost-effective compared to single-agent therapy. However, the preferred option for patients with recurrent platinum-resistant ovarian cancer appears to be supportive care (no chemotherapy) or single-agent therapy.
  
  
  CONCLUSIONS
  Many therapeutic choices are cost-effective in the treatment of ovarian cancer. Cost-effectiveness models offer one way to examine options in the management of a disease. The quality of life of the patient should be the most important factor in any management decision and is incorporated into well-designed studies on cost-effectiveness.
authors.affiliation: Duke University Medical Center, Division of Gynecologic Oncology, DUMC 3079, Durham, NC 27710, USA. Gregory.sfakianos@duke.edu
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Sfakianos
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Havrilesky
mesh_terms: D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000628:therapy; D011788:Quality of Life