title: Cost-Effectiveness of Intensive Vs. Standard Follow-Up Models for Patients with Breast Cancer in Shiraz, Iran
abstract: Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently,
  there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement
  among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness
  of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This
  cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified
  and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up
  models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected
  costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The
  results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62
  and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest
  sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall,
  the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.
authors.affiliation: Department of  Health Service Administration, School of  Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. Email:askariam@sums.ac.ir
authors.forename: Nahid
authors.initials: N
authors.lastname: Hatam
authors.forename: Niloofar
authors.initials: N
authors.lastname: Ahmadloo
authors.forename: Mina
authors.initials: M
authors.lastname: Vazirzadeh
authors.forename: Abdossaleh
authors.initials: A
authors.lastname: Jafari
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Askarian
keywords: Breast cancer; cost-effectiveness; follow-up; intensive; standard