title: Chemotherapy administration: modelling the costs of alternative protocols.
abstract: OBJECTIVE
  The increasing cost of chemotherapy is placing greater pressures on limited healthcare budgets. A potentially important, but often overlooked, aspect of chemotherapy is the cost associated with administration. This study aims to develop a better understanding of these costs, and in doing so, develop a model to estimate the comparative cost of administering alternative chemotherapy protocols for economic evaluation or local decision making.
  
  
  METHODS
  We identified the potential tasks and choices related to administering intravenous chemotherapy, grouped tasks according to anticipated resource use, and allocated costs to each task using data from an evidence-based collection of cancer protocols or from primary data collection. The resources were costed from a healthcare system perspective using standard data sources within Australia. The model was applied to alternative protocols used in the treatment of three different cancers: locally advanced and metastatic non-small-cell lung cancer, adjuvant colorectal cancer and adjuvant breast cancer.
  
  
  RESULTS
  For the three cancer types examined, the cost of completed administration ranged from 1274 Australian dollars ($A) to $A3015 (year 2009 values) for 13 different protocols potentially used for the initial treatment of locally advanced and metastatic non-small-cell lung cancer; $A5175-8445 for seven protocols for adjuvant colorectal cancer treatment; and $A1494-4074 for seven protocols for adjuvant breast cancer treatment.
  
  
  CONCLUSIONS
  The results are of practical significance to those undertaking economic evaluations and to decision makers who use this information within the area of chemotherapy. The examples used suggest that administration costs per visit varied inversely with the number of visits. The results provide information where little has previously been available and may allow decisions about costs and resource allocation to be made with more certainty. Although our model uses costs from the public health system within an Australian state (New South Wales), it can be adapted for use in other jurisdictions.
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology Sydney, NSW, Australia. phaywoodnewzealand@gmail.com
authors.forename: Philip
authors.initials: P
authors.lastname: Haywood
authors.forename: Johan
authors.initials: J
authors.lastname: de Raad
authors.forename: Kees
authors.initials: K
authors.lastname: van Gool
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
authors.forename: Gisselle
authors.initials: G
authors.lastname: Gallego
authors.forename: Sallie-Anne
authors.initials: SA
authors.lastname: Pearson
authors.forename: Margaret
authors.initials: M
authors.lastname: Faedo
authors.forename: Robyn
authors.initials: R
authors.lastname: Ward
mesh_terms: D061605:Administration, Intravenous; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001315:Australia; D001943:Breast Neoplasms / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000191:economics / Q000379:methods; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D003657:Decision Making; D016527:Drug Costs; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D018803:Models, Economic; D009362:Neoplasm Metastasis; D009517:New South Wales
chemical_list: D000970:Antineoplastic Agents