File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Optimizing resource allocation for breast cancer prevention and care among Hong Kong Chinese women

TitleOptimizing resource allocation for breast cancer prevention and care among Hong Kong Chinese women
Authors
KeywordsBreast Cancer
Cancer Care
Chinese
Cost-Effectiveness Analysis
Resource Allocation
Issue Date2012
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 2012, v. 118 n. 18, p. 4394-4403 How to Cite?
AbstractBACKGROUND: Recommendations about funding of interventions through the full spectrum of the disease often have been made in isolation. The authors of this report optimized budgetary allocations by comparing cost-effectiveness data for different preventive and management strategies throughout the disease course for breast cancer in Hong Kong (HK) Chinese women. METHODS: Nesting a state-transition Markov model within a generalized cost-effectiveness analytic framework, costs and quality-adjusted life-years (QALYs) were compared to estimate average cost-effectiveness ratios for the following interventions at the population level: biennial mass mammography (ages 40-69 years or ages 40-79 years), reduced waiting time for postoperative radiotherapy (by 15% or by 25%), adjuvant endocrine therapy (either upfront aromatase inhibitor [AI] therapy or sequentially with tamoxifen followed by AI) in postmenopausal women with estrogen receptor-positive disease, targeted immunotherapy in those with tumors that over express human epidermal growth factor receptor 2, and enhanced palliative services (either at home or as an inpatient). Usual care for eligible patients in the public sector was the comparator. RESULTS: In descending order, the optimal allocation of additional resources for breast cancer would be the following: a 25% reduction in waiting time for postoperative radiotherapy (in US dollars: $5000 per QALY); enhanced, home-based palliative care ($7105 per QALY); adjuvant, sequential endocrine therapy ($17,963 per QALY); targeted immunotherapy ($62,092 per QALY); and mass mammography screening of women ages 40 to 69 years ($72,576 per QALY). CONCLUSIONS: Given the lower disease risk and different age profiles of patients in HK Chinese, among other newly emergent and emerging economies with similar transitioning epidemiologic profiles, the current findings provided direct evidence to support policy decisions that may be dissimilar to current Western practice. Cancer 2012. © 2012 American Cancer Society.
Persistent Identifierhttp://hdl.handle.net/10722/151765
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorTsang, JWHen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2012-06-26T06:28:02Z-
dc.date.available2012-06-26T06:28:02Z-
dc.date.issued2012en_HK
dc.identifier.citationCancer, 2012, v. 118 n. 18, p. 4394-4403en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/151765-
dc.description.abstractBACKGROUND: Recommendations about funding of interventions through the full spectrum of the disease often have been made in isolation. The authors of this report optimized budgetary allocations by comparing cost-effectiveness data for different preventive and management strategies throughout the disease course for breast cancer in Hong Kong (HK) Chinese women. METHODS: Nesting a state-transition Markov model within a generalized cost-effectiveness analytic framework, costs and quality-adjusted life-years (QALYs) were compared to estimate average cost-effectiveness ratios for the following interventions at the population level: biennial mass mammography (ages 40-69 years or ages 40-79 years), reduced waiting time for postoperative radiotherapy (by 15% or by 25%), adjuvant endocrine therapy (either upfront aromatase inhibitor [AI] therapy or sequentially with tamoxifen followed by AI) in postmenopausal women with estrogen receptor-positive disease, targeted immunotherapy in those with tumors that over express human epidermal growth factor receptor 2, and enhanced palliative services (either at home or as an inpatient). Usual care for eligible patients in the public sector was the comparator. RESULTS: In descending order, the optimal allocation of additional resources for breast cancer would be the following: a 25% reduction in waiting time for postoperative radiotherapy (in US dollars: $5000 per QALY); enhanced, home-based palliative care ($7105 per QALY); adjuvant, sequential endocrine therapy ($17,963 per QALY); targeted immunotherapy ($62,092 per QALY); and mass mammography screening of women ages 40 to 69 years ($72,576 per QALY). CONCLUSIONS: Given the lower disease risk and different age profiles of patients in HK Chinese, among other newly emergent and emerging economies with similar transitioning epidemiologic profiles, the current findings provided direct evidence to support policy decisions that may be dissimilar to current Western practice. Cancer 2012. © 2012 American Cancer Society.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.subjectBreast Canceren_US
dc.subjectCancer Careen_US
dc.subjectChineseen_US
dc.subjectCost-Effectiveness Analysisen_US
dc.subjectResource Allocationen_US
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshBreast Neoplasms - prevention & control - radiotherapy - surgery - therapyen_HK
dc.subject.meshCost-Benefit Analysisen_HK
dc.subject.meshDecision Makingen_HK
dc.subject.meshEarly Detection of Cancer - economicsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHealth Care Rationing - economicsen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMammography - economicsen_HK
dc.subject.meshMarkov Chainsen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPalliative Careen_HK
dc.subject.meshPolicy Makingen_HK
dc.subject.meshQuality-Adjusted Life Yearsen_HK
dc.titleOptimizing resource allocation for breast cancer prevention and care among Hong Kong Chinese womenen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.emailTsang, JWH: jwhtsang@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hkucc.hku.hken_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.identifier.authorityTsang, JWH=rp00278en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/cncr.27448en_HK
dc.identifier.pmid22359352en_HK
dc.identifier.scopuseid_2-s2.0-84865963135en_HK
dc.identifier.hkuros210707-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84865963135&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume118en_HK
dc.identifier.issue18en_HK
dc.identifier.spage4394en_HK
dc.identifier.epage4403en_HK
dc.identifier.eissn1097-0142-
dc.identifier.isiWOS:000308404100008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, IOL=7102513940en_HK
dc.identifier.scopusauthoridTsang, JWH=35141929400en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats