title: Economic analyses in squamous cell carcinoma of the head and neck: a review of the literature from a clinical perspective.
abstract: The purpose of this review was to describe cost-effectiveness and cost analysis studies across treatment modalities for squamous cell carcinoma of the head and neck (SCCHN), while placing their results in context of the current clinical practice. We performed a literature search in PubMed for English-language studies addressing economic analyses of treatment modalities for SCCHN published from January 2000 to March 2013. We also performed an additional search for related studies published by the National Institute for Health and Clinical Excellence in the United Kingdom. Identified articles were classified into 3 clinical approaches (organ preservation, radiation therapy modalities, and chemotherapy regimens) and into 2 types of economic studies (cost analysis and cost-effectiveness/cost-utility studies). All cost estimates were normalized to US dollars, year 2013 values. Our search yielded 23 articles: 13 related to organ preservation approaches, 5 to radiation therapy modalities, and 5 to chemotherapy regimens. In general, studies analyzed different questions and modalities, making it difficult to reach a conclusion. Even when restricted to comparisons of modalities within the same clinical approach, studies often yielded conflicting findings. The heterogeneity across economic studies of SCCHN should be carefully understood in light of the modeling assumptions and limitations of each study and placed in context with relevant settings of clinical practices and study perspectives. Furthermore, the scarcity of comparative effectiveness and quality-of-life data poses unique challenges for conducting economic analyses for a resource-intensive disease, such as SCCHN, that requires a multimodal care. Future research is needed to better understand how to compare the costs and cost-effectiveness of different modalities for SCCHN.
authors.affiliation: The University of Chicago Medicine, Chicago, Illinois. Electronic address: jdesouza@medicine.bsd.uchicago.edu.
authors.forename: Jonas A
authors.initials: JA
authors.lastname: de Souza
authors.affiliation: Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
authors.forename: Iuri A
authors.initials: IA
authors.lastname: Santana
authors.affiliation: Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Castro
authors.affiliation: Johns Hopkins Singapore International Medical Centre, Singapore.
authors.forename: Gilberto
authors.initials: G
authors.lastname: de Lima Lopes
authors.affiliation: The University of Chicago Medicine, Chicago, Illinois.
authors.forename: Ya-Chen
authors.initials: YC
authors.lastname: Tina Shih
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D001918:Brachytherapy / Q000191:economics; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D037981:Neck Dissection / Q000191:economics* / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D059351:Organ Sparing Treatments / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D011878:Radiotherapy / Q000191:economics* / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000191:economics; D000077195:Squamous Cell Carcinoma of Head and Neck; D013514:Surgical Procedures, Operative / Q000191:economics
chemical_list: D000970:Antineoplastic Agents