J. Beca

Cost Effectiveness of EML4-ALK Fusion Testing and First-Line Crizotinib Treatment for Patients With Advanced ALK-Positive Non–Small-Cell Lung Cancer

PURPOSE ALK-targeted therapy with crizotinib offers significant improvement in clinical outcomes for the treatment of EML4-ALK fusion-positive non-small-cell lung cancer (NSCLC). We estimated the cost effectiveness of EML4-ALK fusion testing in combination with targeted first-line crizotinib treatment in Ontario. PATIENTS AND METHODS A cost-effectiveness analysis was conducted using a Markov model from the Canadian Public health (Ontario) perspective and a lifetime horizon in patients with stage IV NSCLC with nonsquamous histology. Transition probabilities and mortality rates were calculated from the Ontario Cancer Registry and Cancer Care Ontario New Drug Funding Program (CCO NDFP). Costs were obtained from the Ontario Case Costing Initiative, CCO NDFP, University Health Network, and literature. RESULTS Molecular testing with first-line targeted crizotinib treatment in the population with advanced nonsquamous NSCLC resulted in a gain of 0.011 quality-adjusted life-years (QALYs) compared with standard care. The incremental cost was Canadian

Improving chronic disease prevention and screening in primary care: results of the BETTER pragmatic cluster randomized controlled trial

2,725 per patient, and the incremental cost-effectiveness ratio (ICER) was

Cost-effectiveness of intensity-modulated radiotherapy in oropharyngeal cancer.

255,970 per QALY gained. Among patients with known EML4-ALK-positive advanced NSCLC, first-line crizotinib therapy provided 0.379 additional QALYs, cost an additional

Cost-effectiveness of intensity-modulated radiotherapy in prostate cancer.

95,043 compared with standard care, and produced an ICER of

Does it Matter Whether Canada’s Separate Health Technology Assessment Process for Cancer Drugs has an Economic Rationale?

250,632 per QALY gained. The major driver of cost effectiveness was drug price. CONCLUSION EML4-ALK fusion testing in stage IV nonsquamous NSCLC with crizotinib treatment for ALK-positive patients is not cost effective in the setting of high drug costs and a low biomarker frequency in the population.

Economic evaluation of hormonal therapies for postmenopausal women with estrogen receptor–positive early breast cancer in Canada

BackgroundPrimary care provides most of the evidence-based chronic disease prevention and screening services offered by the healthcare system. However, there remains a gap between recommended preventive services and actual practice. This trial (the BETTER Trial) aimed to improve preventive care of heart disease, diabetes, colorectal, breast and cervical cancers, and relevant lifestyle factors through a practice facilitation intervention set in primary care.MethodsPragmatic two-way factorial cluster RCT with Primary Care Physicians’ practices as the unit of allocation and individual patients as the unit of analysis. The setting was urban Primary Care Team practices in two Canadian provinces. Eight Primary Care Team practices were randomly assigned to receive the practice-level intervention or wait-list control; 4 physicians in each team (32 physicians) were randomly assigned to receive the patient-level intervention or wait-list control. Patients randomly selected from physicians’ rosters were stratified into two groups: 1) general and 2) moderate mental illness. The interventions involved a multifaceted, evidence-based, tailored practice-level intervention with a Practice Facilitator, and a patient-level intervention involving a one-hour visit with a Prevention Practitioner where patients received a tailored ‘prevention prescription’. The primary outcome was a composite Summary Quality Index of 28 evidence-based chronic disease prevention and screening actions with pre-defined targets, expressed as the ratio of eligible actions at baseline that were met at follow-up. A cost-effectiveness analysis was conducted.Results789 of 1,260 (63%) eligible patients participated. On average, patients were eligible for 8.96 (SD 3.2) actions at baseline. In the adjusted analysis, control patients met 23.1% (95% CI: 19.2% to 27.1%) of target actions, compared to 28.5% (95% CI: 20.9% to 36.0%) receiving the practice-level intervention, 55.6% (95% CI: 49.0% to 62.1%) receiving the patient-level intervention, and 58.9% (95% CI: 54.7% to 63.1%) receiving both practice- and patient-level interventions (patient-level intervention versus control, P < 0.001). The benefit of the patient-level intervention was seen in both strata. The extra cost of the intervention was

Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario

26.43CAN (95% CI:

Cost-effectiveness of pazopanib: an example of improved transparency and accessibility of industry-sponsored economic evaluations through publication in peer-reviewed journals

16 to

Oncology Modeling for Fun and Profit! Key Steps for Busy Analysts in Health Technology Assessment

44) per additional action met.ConclusionsA Prevention Practitioner can improve the implementation of clinically important prevention and screening for chronic diseases in a cost-effective manner.

Systemic treatment patterns in small bowel and appendiceal adenocarcinomas (SBA and AA): A population-based study.

AIMS Intensity-modulated radiotherapy (IMRT) is an advanced radiation technique that is particularly suited to treating head and neck cancers because it can conform a high dose to the target volume while preserving the tissue function of neighbouring structures. The objective of this study was to compare the cost and effectiveness of IMRT with three-dimensional conformal radiotherapy (3DCRT) for the treatment of locally advanced oropharyngeal cancer. MATERIALS AND METHODS We developed a Markov model to estimate the incremental cost per quality-adjusted life-year (QALY) gained by IMRT from the perspective of the Ministry of Health. The costs of IMRT and 3DCRT were estimated through activity-based costing, incorporating input from radiation oncologists, physicists and radiation therapists. We obtained clinical effectiveness estimates from published studies and calculated the number needed to treat to avoid a case of severe long-term xerostomia using data from a randomised controlled trial. RESULTS The delivery of IMRT produced 0.48 more QALYs than 3DCRT at an additional cost of