Economic evaluation of interventions for malignant neoplasms in Spain: systematic review and comparative analysis.
OBJECTIVE
To review standard methods used to evaluate the efficiency of oncology interventions, comparing their main characteristics with those of the studies aimed for other conditions.


METHODS
We performed a systematic review and comparative analysis calculating odds ratios (OR). We searched the biomedical literature to assess economic evaluation studies on malignant neoplasms in Spain published between 1983 and 2008. Their characteristics were reviewed and summarised, including the following variables: journal and year of publication, intervention, type and design of study, perspective, type of costs, financing source, and decision-making recommendations.


RESULTS
Sixty-three studies were included. Main characteristics of the reports were: cost-effectiveness analysis and therapeutic interventions (60.3%; n=38). Seventeen studies (27.0%) used an observational design. Economic evaluations of malignant neoplasms showed the following associations (compared to those studies addressing other causes [n=411]): cost minimisation analysis (OR: 1.73; 95% confidence interval [CI]: 0.91-3.27), diagnostic interventions (OR: 2.18; 95% CI: 1.07-4.43), decision analysis design (OR: 0.46; 95% CI: 0.24-0.87), societal perspective (OR: 0.20; 95% CI: 0.05-0.86) and for-profit source of financing (OR: 0.52; 95% CI: 0.30-0.93).


CONCLUSIONS
Economic evaluations of interventions for malignant neoplasms are not common despite the gradual increase produced during recent years in Spain. Reports presented heterogeneity in the quality of the information regarding the methods and the data sources used. Further efficiency evaluations of oncology interventions are needed and methodological quality should be warranted.
Fundación Instituto de Investigación en Servicios de Salud, Valencia, España. ferran catala@hotmail.com
F
F
Catalá-López
A
A
García-Altés
E
E
Álvarez-Martín
R
R
Gènova-Maleras
C
C
Morant-Ginestar
E
E
Arana
D015706:Bibliometrics; D002986:Clinical Trials as Topic / Q000191:economics; D017046:Cost Savings; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data*; D003661:Decision Support Techniques; D005381:Financing, Organized; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D055811:Journal Impact Factor; D008962:Models, Theoretical; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control / Q000534:rehabilitation / Q000628:therapy; D016017:Odds Ratio; D012107:Research Design; D013030:Spain; D016896:Treatment Outcome