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. (2019) Context-specific economic evaluation for molecular pathology tests: An application in colorectal cancer in the West of Scotland. International Journal of Technology Assessment in Health Care, 35(4), pp. 327-333. (doi: 10.1017/S026646231900045X) (PMID:31292015)

Abstract

The 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. We 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. A 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. The 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Graham, Dr Janet and Bouttell, Dr Janet and Hawkins, Professor Neil
• Authors: Bouttell, J., Tan, Y. Y., Creed, D., McGaffin, G., Hawkins, N., McLaughlin, R., Smith, G., Westwood, P., Williams, N., and Graham, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: International Journal of Technology Assessment in Health Care
• Publisher: Cambridge University Press
• ISSN: 0266-4623
• ISSN (Online): 1471-6348
• Published Online: 11 July 2019
• Copyright Holders: Copyright © 2019 Cambridge University Press
• First Published: First published in International Journal of Technology Assessment in Health Care 35(4):327-333
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher