Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 4S1 ( October-December, 2018 ) > List of Articles


Cost-effectiveness Analysis on Advanced Cervical Carcinoma Patients at Dr Mohammad Hoesin General Hospital Palembang, South Sumatra, Indonesia

Rizal Sanif, Wahyu Sulistiadi, Heriadi Manan, Rachmat Hidayat

Keywords : Advanced cervical carcinoma, Chemotherapy, Chemoradiation, Cost-effectiveness analysis

Citation Information : Sanif R, Sulistiadi W, Manan H, Hidayat R. Cost-effectiveness Analysis on Advanced Cervical Carcinoma Patients at Dr Mohammad Hoesin General Hospital Palembang, South Sumatra, Indonesia. J South Asian Feder Obs Gynae 2018; 10 (4S1):316-320.

DOI: 10.5005/jp-journals-10006-1615

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Introduction: The management of advanced cervical carcinoma still faces many obstacles in developing countries like Indonesia, and this has an impact on the efficacy of treatment and delays in treatment. Objective: To compare the cost-effectiveness on advanced cervical carcinoma management between among patients treated with fully dosed chemotherapy once every in three weeks, and chemoradiation combination therapy in divided doses chemotherapy with radiation every week. Methods: A retrospective study has been done from January to December 2014 at Mohammad Hoesin, General Hospital in Palembang. There were 105 patients newly diagnosed with advanced cervical carcinoma who fulfilled the criteria inclusion and divided into two groups; 66 patients were in the chemotherapy group and 39 patients were in the chemoradiation group. The total cost from diagnosis to treatment was analyzed by using activity-based costing (ABC) and cost-effectiveness ratio (CER) methods between chemotherapy and chemoradiation. Result: This study showed that there were 64.76% of patients revealed a positive reaction to the chemoradiation and 57.57% to the chemotherapy. These differences wsere caused by the price of medical devices (62.48 % for chemotherapy, 67.6628% for chemoradiation). On the other hand, the operational cost for chemotherapy was cheaper than of chemoradiation, 1, 502, 444, 446 IDR and 1, 591, 510, 404 IDR, respectively. The maintenance cost of chemotherapy was lower than the maintenance cost of chemoradiation. The total budget of chemotherapy for cervical carcinoma management (43, 345, 805) was cheaper than of the total budget of chemoradiation therapy (80, 644, 767). The CER for chemoradiation is lower than the CER for chemotherapy in terms of complete, partial or progressive clinical responses. Conclusion: It can be concluded that the use of chemoradiation modality was more effective than the use of chemotherapy.

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  1. World Health Organization. International Agency for Research on Cancer. Press Release N 223. 12 December 2013
  2. Ferlay J, Shin HR, et al. GLOBOCAN 2008, cancer incidence and mortality Worldwide: IARC Cancer Base No. 10. Lyon, France. International Agency for Research on Cancer; 2010. Search Google Scholar. Available at: Accessed: September 1, 2014
  3. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cervical cancer. National Comprehensive Cancer Network, Inc. 2006.
  4. Drummond M, Stoddart GL, et al. Methods for the Economic Evaluation of Health care Programmes. Toronto: Oxford University Press; 1988
  5. Haycox A. What is health economics?. Second Edition; 2009.Page 1-8. Liverpool: Hayward medical Pub Supprted by Sanofi-aventis. Available at: RSUP Dr. M. Hoesin Accessed: September 1, 2014
  6. Neumann PJ. Costing and Perspective in Published Cost-Effectiveness Analysis. Med Care 2009;47:S28-S32
  7. Robinson R. Economic Evaluation and Health Care. What does it mean? BMJ 1993;307:60-63
  8. Sorenson C, Tarricone R, et al. Applying health economics for policy decision making: do devices differ from drugs? Europace 2011;13:ii54-ii58.
  9. Chaikledkaew U, Teerawattananon. Presentatin of economic evaluation results. J Med Assoc Thai 2008;91(Suppl 2):66-73.
  10. Scandurra G, Scibilia G, et al. Efficacy and tolerability of paclitaxel, ifosfamide, and cisplatin as a neoadjuvant chemotherapy in locally advanced cervical carcinoma. J Gynecol Oncol 2015;26(2):118-124.
  11. Miše BP, Jelavic TB, et al. Long follow-up of patients with locally advanced cervical cancer treated with concomitant chemo-brachyradiotherapy with cisplatin and ifosfamide followed by consolidation chemotherapy. In Int J Gynecol Cancer 2015; 25: 315-319.
  12. Drummond M. Experimental versus observational data in the economic evaluation of pharmaceuticals. Med Care 1988;2: S12-S17.
  13. Drummond M, Sculpher M. Common Methodological Flaws in Economic Evaluations. Med Care 2005;43:II-5–II-14.
  14. Marino P, Houvenaeghel G, et al. Cost effectiveness of conventional vs robotic-assisted laparoscopy in gynecologic indication. Int J Gynecol Cancer 2015;25:1102-1108.
  15. O'Reilly D, Gaebel K, et al. Health economic evaluations help inform payers of the best use of scarce health care resources. Int J Circumpolar Health 2011;4:419-427.
  16. Phippen NT, Leath III CA, et al. Cost effectiveness of concurrent gemcitabine and cisplatin with radiation followed by adjuvant gemcitabine and cisplatin in patients with stages IIB to IVA carcinoma of the cervix. Gynecol Oncol 2012; 127: 267-272.
  17. Smith B, Cohn DE, et al. Is the progression free survival advantage of concurrent gem-citabine plus cisplatin and radiation followed by adjuvant gemcitabine and cisplatin in patients with advanced cervical cancer worth the additional cost? A cost-effectiveness analysis. Gyn Onc 2013;130:416-420.
  18. Perri T, Issakov G, et al. Effect of treatment delay on survival in patients with cervical cancer a historical cohort study. Int J Gynecol Cancer 2014;24:1326-1332.
  19. Hoch JS, Dewa CS. An Introduction to economic evaluation: What's in a name?. Can J Psychiatry 2005;50(3):159-166.
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