title: Costs of cancer care for use in economic evaluation: a UK analysis of patient-level routine health system data.
abstract: BACKGROUND
  The rising financial burden of cancer on health-care systems worldwide has led to the increased demand for evidence-based research on which to base reimbursement decisions. Economic evaluations are an integral component of this necessary research. Ascertainment of reliable health-care cost and quality-of-life estimates to inform such studies has historically been challenging, but recent advances in informatics in the United Kingdom provide new opportunities.
  
  
  METHODS
  The costs of hospital care for breast, colorectal and prostate cancer disease-free survivors were calculated over 15 months from initial diagnosis of cancer using routinely collected data within a UK National Health Service (NHS) Hospital Trust. Costs were linked at patient level to patient-reported outcomes and registry-derived sociodemographic factors. Predictors of cost and the relationship between costs and patient-reported utility were examined.
  
  
  RESULTS
  The study population included 223 breast cancer patients, 145 colorectal and 104 prostate cancer patients. The mean 15-month cumulative health-care costs were £12 595 (95% CI £11 517-£13 722), £12 643 (£11 282-£14 102) and £3722 (£3263-£4208), per-patient respectively. The majority of costs occurred within the first 6 months from diagnosis. Clinical stage was the most important predictor of costs for all cancer types. EQ-5D score was predictive of costs in colorectal cancer but not in breast or prostate cancer.
  
  
  CONCLUSIONS
  It is now possible to evaluate health-care cost using routine NHS data sets. Such methods can be utilised in future retrospective and prospective studies to efficiently collect economic data.
authors.affiliation: 1] Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK [2] St James Institute of Oncology, Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors.forename: P S
authors.initials: PS
authors.lastname: Hall
authors.affiliation: Manchester Royal Infirmary, Manchester Institute of Nephrology and Transplantation, Oxford Road, Manchester M139WL, UK.
authors.forename: P
authors.initials: P
authors.lastname: Hamilton
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK.
authors.forename: C T
authors.initials: CT
authors.lastname: Hulme
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Meads
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors.forename: H
authors.initials: H
authors.lastname: Jones
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors.forename: A
authors.initials: A
authors.lastname: Newsham
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK.
authors.forename: J
authors.initials: J
authors.lastname: Marti
authors.affiliation: Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK.
authors.forename: A F
authors.initials: AF
authors.lastname: Smith
authors.affiliation: Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, South Yorkshire S5 7AU, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mason
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors.forename: G
authors.initials: G
authors.lastname: Velikova
authors.affiliation: School of Social, Psychological and Communication Sciences, Faculty of Health and Social Sciences, Leeds Beckett University, Calverley Building, City Campus, Leeds LS1 3HE, UK.
authors.forename: L
authors.initials: L
authors.lastname: Ashley
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors.forename: P
authors.initials: P
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000191:economics* / Q000378:metabolism / Q000628:therapy*; D016019:Survival Analysis; D006113:United Kingdom; D055815:Young Adult