Context-Specific Economic Evaluation for Molecular Pathology Tests: An Application in Colorectal Cancer in the West of Scotland. Bouttell, J.; Tan, Y. Y.; Creed, D.; McGaffin, G.; Hawkins, N.; McLaughlin, R.; Smith, G.; Westwood, P.; Williams, N.; and Graham, J. International Journal of Technology Assessment in Health Care.
Context-Specific Economic Evaluation for Molecular Pathology Tests: An Application in Colorectal Cancer in the West of Scotland [link]Paper  doi  abstract   bibtex   
ObjectivesThe cost-effectiveness of molecular pathology testing is highly context dependent. The field is fast-moving, and national health technology assessment may not be relevant or timely for local decision makers. This study illustrates a method of context-specific economic evaluation that can be carried out in a limited timescale without extensive resources.MethodsWe established a multi-disciplinary group including an oncologist, pathologists and a health economist. We set out diagnostic and treatment pathways and costs using registry data, health technology assessments, guidelines, audit data, and estimates from the group. Sensitivity analysis varied input parameters across plausible ranges. The evaluation setting was the West of Scotland and UK NHS perspective was adopted. The evaluation was assessed against the AdHopHTA checklist for hospital-based health technology assessment.ResultsA context-specific economic evaluation could be carried out on a timely basis using limited resources. The evaluation met all relevant criteria in the AdHopHTA checklist. Health outcomes were expected to be at least equal to the current strategy. Annual cost savings of £637,000 were estimated resulting primarily from a reduction in the proportion of patients receiving intravenous infusional chemotherapy regimens. The result was not sensitive to any parameter. The data driving the main cost saving came from a small clinical audit. We recommended this finding was confirmed in a larger population.ConclusionsThe method could be used to evaluate testing changes elsewhere. The results of the case study may be transferable to other jurisdictions where the organization of cancer services is fragmented.
@article{bouttell_context-specific_nodate,
	title = {Context-{Specific} {Economic} {Evaluation} for {Molecular} {Pathology} {Tests}: {An} {Application} in {Colorectal} {Cancer} in the {West} of {Scotland}},
	issn = {0266-4623, 1471-6348},
	shorttitle = {Context-{Specific} {Economic} {Evaluation} for {Molecular} {Pathology} {Tests}},
	url = {https://www.cambridge.org/core/journals/international-journal-of-technology-assessment-in-health-care/article/contextspecific-economic-evaluation-for-molecular-pathology-tests-an-application-in-colorectal-cancer-in-the-west-of-scotland/99C763EE9E5E68BD61B5CA58D605343A},
	doi = {10.1017/S026646231900045X},
	abstract = {ObjectivesThe cost-effectiveness of molecular pathology testing is highly context dependent. The field is fast-moving, and national health technology assessment may not be relevant or timely for local decision makers. This study illustrates a method of context-specific economic evaluation that can be carried out in a limited timescale without extensive resources.MethodsWe established a multi-disciplinary group including an oncologist, pathologists and a health economist. We set out diagnostic and treatment pathways and costs using registry data, health technology assessments, guidelines, audit data, and estimates from the group. Sensitivity analysis varied input parameters across plausible ranges. The evaluation setting was the West of Scotland and UK NHS perspective was adopted. The evaluation was assessed against the AdHopHTA checklist for hospital-based health technology assessment.ResultsA context-specific economic evaluation could be carried out on a timely basis using limited resources. The evaluation met all relevant criteria in the AdHopHTA checklist. Health outcomes were expected to be at least equal to the current strategy. Annual cost savings of £637,000 were estimated resulting primarily from a reduction in the proportion of patients receiving intravenous infusional chemotherapy regimens. The result was not sensitive to any parameter. The data driving the main cost saving came from a small clinical audit. We recommended this finding was confirmed in a larger population.ConclusionsThe method could be used to evaluate testing changes elsewhere. The results of the case study may be transferable to other jurisdictions where the organization of cancer services is fragmented.},
	language = {en},
	urldate = {2019-08-06},
	journal = {International Journal of Technology Assessment in Health Care},
	author = {Bouttell, Janet and Tan, Yun Yi and Creed, David and McGaffin, Gillian and Hawkins, Neil and McLaughlin, Ruth and Smith, Graeme and Westwood, Paul and Williams, Nicola and Graham, Janet},
	keywords = {Colorectal neoplasms, Economic evaluation, Genetic testing},
	pages = {1--7}
}
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