Abstract
Background For patients receiving add-on Viscum album L. (VA) treatments for late-stage pancreatic cancer, an improved overall survival (OS) was observed. Only limited information regarding cost-effectiveness (CE) for comparisons between standard of care and standard of care plus add-on VA in stage IV pancreatic cancer treatment is available. The present study assessed the costs and cost-effectiveness of standard of care plus VA (V) compared to standard of care alone (C) for a hospital in Germany. Methods An observational study was conducted using data from the Network Oncology clinical registry. Patients included had stage IV pancreatic cancer at diagnosis and received C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. Results 88 patients (C or n = 34; V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. n = 34; C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. C or V treatment in a certified German Cancer Center. Cost and cost-effectiveness analyses (CEA) including the analysis of the incremental cost-effectiveness ratios (ICER) were performed from the hospital's perspective based on routine data from the financial controlling department and observed data on OS. The primary result of the analysis was tested for robustness in a bootstrap-based sensitivity analysis. C or Conclusion Based on this CEA analysis, from the hospital's point of view, the costs per mean month of OS and per mean hospital stay were lower for patients under combinational standard of care plus VA compared to patients receiving standard of care alone for the treatment of stage IV pancreatic cancer. Further prospective cost-effectiveness studies are mandatory to reevaluate our findings.
Highlights
Integrative oncology (IO) has been enormously developed and internationally established during the last decades in academic and public cancer centres [1]
Loss to follow-up was defined as no follow-up visits. e CE analysis took the perspective of the hospital Gemeinschaftskrankenhaus Havelhohe Berlin (GKHB), at which the patients were treated and which is an Anthroposophic-integrative working hospital harbouring three German Cancer Society (DKG, Deutsche Krebsgesellschaft) certified Organ Centres as a DKG-certified Cancer Centre. e study served as a feasibility study for subsequent IO cost-effectiveness studies. e primary objective of this analysis was to evaluate the CE of Viscum album L. (VA) in addition to standard of care compared to standard of care alone in stage IV pancreatic cancer patients from the hospital’s perspective
From the hospital’s point of view, our analysis revealed that compared to standard of care (C), patients treated with the combinational therapy (V) received a costeffective therapy with relevant total hospital’s savings per mean month overall survival (OS) and per mean hospital stay
Summary
Integrative oncology (IO) has been enormously developed and internationally established during the last decades in academic and public cancer centres [1]. As limited information regarding CE comparisons between standard of care and IO concepts including add-on VA is available and considering the recent efficacy data for add-on VA therapy for mPC, there was an interest in the cost-effectiveness of the combinational therapy compared with the standard of care treatment. Limited information regarding cost-effectiveness (CE) for comparisons between standard of care and standard of care plus add-on VA in stage IV pancreatic cancer treatment is available. Based on this CEA analysis, from the hospital’s point of view, the costs per mean month of OS and per mean hospital stay were lower for patients under combinational standard of care plus VA compared to patients receiving standard of care alone for the treatment of stage IV pancreatic cancer. Further prospective costeffectiveness studies are mandatory to reevaluate our findings
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