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Cost-effectiveness of treatments for the management of bone metastases : a systematic literature review
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Andronis, L. (Lazaros) , Goranitis, I., Bayliss, S. and Duarte, R. (2018) Cost-effectiveness of treatments for the management of bone metastases : a systematic literature review. PharmacoEconomics, 36 (3). pp. 301-322. doi:10.1007/s40273-017-0595-0
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Official URL: https://doi.org/10.1007/s40273-017-0595-0
Abstract
Background:
Metastatic cancers occur when cancer cells break away from the primary tumour. One of the most common sites of metastasis is the bone. Several therapeutic options are currently available for managing bone metastases. In a resource constrained environment, policy makers and practitioners need to know which options are cost-effective.
Objective:
To review and appraise published economic evaluations on treatments for the management of bone metastases.
Methods:
We searched eight bibliographic databases (MEDLINE, MEDLINE in Process, EMBASE, CSDR, DARE, HTA, EED and CPCI) for relevant economic evaluations published from each database’s inception date until March 2017. Study selection, quality assessment and data extraction were carried out according to published guidelines.
Results:
Twenty-four relevant economic analyses were identified. Seventeen of these studies focus on bone metastases resulting from a particular type of cancer (prostate (n=8), breast (n=7), lung (n=1) or renal (n=1)) while seven report results for various primary tumours. Across types of cancer, evidence suggests that bisphosphonates result in lower morbidity and improved quality of life, for an additional cost which is typically below conventional cost-effectiveness thresholds. While denosumab leads to health gains compared to zoledronic acid, it also results in substantial additional costs and it is unlikely to represent value for money. The limited literature on the radiopharmaceutical strontium-89 (Sr89) and external beam radiotherapy (EBR) suggest that these treatments are cost-effective compared to no treatment.
Conclusions:
The reviewed evidence suggests that bisphosphonate treatments are cost-effective options for bone metastases, while denosumab is unlikely to represent value for money. Evidence on EBR and Sr89 is limited and less conclusive.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Bone metastasis -- Treatment -- Cost effectiveness, Medical economics, Systematic reviews (Medical research) | ||||||||
| Journal or Publication Title: | PharmacoEconomics | ||||||||
| Publisher: | Adis International Ltd. | ||||||||
| ISSN: | 1170-7690 | ||||||||
| Official Date: | March 2018 | ||||||||
| Dates: |
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| Volume: | 36 | ||||||||
| Number: | 3 | ||||||||
| Page Range: | pp. 301-322 | ||||||||
| DOI: | 10.1007/s40273-017-0595-0 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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