title: Treatment patterns, health care utilization, and costs of ovarian cancer in Central and Eastern Europe using a Delphi panel based on a retrospective chart review.
abstract: OBJECTIVE
  Despite the considerable disease burden of ovarian cancer, there were no cost studies in Central and Eastern Europe. This study aimed to describe treatment patterns, health care utilization, and costs associated with treating ovarian cancer in Hungary, Poland, Serbia, and Slovakia.
  
  
  METHODS
  Overall clinical practice for management of epithelial ovarian cancer was investigated through a 3-round Delphi panel. Experts completed a survey based on the chart review (n = 1542). The survey was developed based on clinical guidelines and the International Federation of Gynecology and Obstetrics Annual Report. Means, ranges, and outlier values were discussed with the experts during a telephone interview. Finally, consensus estimates were obtained in face-to-face workshops. Based on these results, overall cost of ovarian cancer was estimated using a Markov model.
  
  
  RESULTS
  The patients included in the chart review were followed up from presurgical diagnosis and in each phase of treatment, that is, surgical staging and primary surgery, chemotherapy and chemotherapy monitoring, follow-up, and palliative care. The 5-year overall cost per patient was €14,100 to €16,300 in Hungary, €14,600 to €15,800 in Poland, €7600 to €8100 in Serbia, and €12,400 to €14,500 in Slovakia. The main components were chemotherapy-associated costs (68%-74% of the total cost), followed by cost of primary treatment with surgery (15%-21%) and palliative care (3%-10%).
  
  
  CONCLUSIONS
  Patients with ovarian cancer consume considerable health care resources and incur substantial costs in Central and Eastern Europe. These findings may prove useful for clinicians and decision makers in understanding the economic implications of managing ovarian cancer in Central and Eastern Europe and the need for innovative therapies.
authors.affiliation: OptumInsight, Stockholm, Sweden. kun.kim@optum.com
authors.forename: Kun
authors.initials: K
authors.lastname: Kim
authors.forename: Emma
authors.initials: E
authors.lastname: Hernlund
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Hernadi
authors.forename: János
authors.initials: J
authors.lastname: Révész
authors.forename: Imre
authors.initials: I
authors.lastname: Pete
authors.forename: András
authors.initials: A
authors.lastname: Szánthó
authors.forename: Lubomir
authors.initials: L
authors.lastname: Bodnar
authors.forename: Rodoslaw
authors.initials: R
authors.lastname: Madry
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Timorek-Lemieszczuk
authors.forename: Tatjana
authors.initials: T
authors.lastname: Bozanovic
authors.forename: Suzana
authors.initials: S
authors.lastname: Vasovic
authors.forename: Zorica
authors.initials: Z
authors.lastname: Tomasevic
authors.forename: Milica
authors.initials: M
authors.lastname: Zivaljevic
authors.forename: Vladimir
authors.initials: V
authors.lastname: Pazin
authors.forename: Tomáš
authors.initials: T
authors.lastname: Minárik
authors.forename: Hana
authors.initials: H
authors.lastname: Garanová
authors.forename: Lýdia
authors.initials: L
authors.lastname: Helpianska
authors.forename: Nahila
authors.initials: N
authors.lastname: Justo
mesh_terms: D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D006814:Hungary; D008390:Markov Chains; D010051:Ovarian Neoplasms / Q000191:economics* / Q000628:therapy; D010166:Palliative Care; D011044:Poland; D011379:Prognosis; D012189:Retrospective Studies; D055771:Serbia; D018154:Slovakia; D062606:Tertiary Care Centers