Abstract

Background/Purpose This study aims to examine the cost effectiveness of treating major cancers compared with other major illnesses in Taiwan. Methods We collected data on 395,330 patients with cancer, 125,277 patients with end-stage renal disease, and 50,481 patients under prolonged mechanical ventilation during 1998–2007. They were followed for 10–13 years to estimate lifetime survival functions using a semiparametric method. EuroQol five-dimension was used to measure the quality of life for 6189 cancer patients and 1401 patients with other illnesses. The mean utility values and healthcare costs reimbursed by the National Health Insurance were multiplied with the corresponding survival probabilities to estimate quality-adjusted life expectancies and lifetime costs, respectively. Data of 22,344 cancer patients under hospice care (considered as a comparison group) were used to conduct a cost-effectiveness analysis. Sensitivity analysis was conducted by assuming patients without treatment survived for 2 years with a quality of life value of 0.5. Results The costs of care for patients under prolonged mechanical ventilation and those with end-stage renal disease were US$41,780–53,708 per quality-adjusted life year (QALY) and US$18,222–18,465 per QALY, respectively, which are equivalent to 2.17–2.79 gross domestic product (GDP) per capita per QALY and 1.18–1.25 GDP per capita per QALY. The costs of care for the nine different cancers were less than 1 GDP per capita per QALY, with those of lung, esophagus, and liver cancers being the highest. Sensitivity analysis showed the same conclusion. Lifetime risks of six out of nine cancer sites show an increased trend. Conclusion Cancer care in Taiwan seemed cost effective compared with that of other illnesses, but prevention is necessary to make the National Health Insurance more sustainable.

Original languageEnglish
Pages (from-to)609-618
Number of pages10
JournalJournal of the Formosan Medical Association
Volume115
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Taiwan
Cost-Benefit Analysis
Quality-Adjusted Life Years
Gross Domestic Product
Neoplasms
Costs and Cost Analysis
Quality of Life
National Health Programs
Artificial Respiration
Therapeutics
Chronic Kidney Failure
Hospice Care
Survival
Liver Neoplasms
Esophageal Neoplasms
Life Expectancy
Health Care Costs
Lung Neoplasms
Patient Care

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{042fd026093348f0b9d55248d4a01354,
title = "Cost effectiveness of cancer treatment in Taiwan",
abstract = "Background/Purpose This study aims to examine the cost effectiveness of treating major cancers compared with other major illnesses in Taiwan. Methods We collected data on 395,330 patients with cancer, 125,277 patients with end-stage renal disease, and 50,481 patients under prolonged mechanical ventilation during 1998–2007. They were followed for 10–13 years to estimate lifetime survival functions using a semiparametric method. EuroQol five-dimension was used to measure the quality of life for 6189 cancer patients and 1401 patients with other illnesses. The mean utility values and healthcare costs reimbursed by the National Health Insurance were multiplied with the corresponding survival probabilities to estimate quality-adjusted life expectancies and lifetime costs, respectively. Data of 22,344 cancer patients under hospice care (considered as a comparison group) were used to conduct a cost-effectiveness analysis. Sensitivity analysis was conducted by assuming patients without treatment survived for 2 years with a quality of life value of 0.5. Results The costs of care for patients under prolonged mechanical ventilation and those with end-stage renal disease were US$41,780–53,708 per quality-adjusted life year (QALY) and US$18,222–18,465 per QALY, respectively, which are equivalent to 2.17–2.79 gross domestic product (GDP) per capita per QALY and 1.18–1.25 GDP per capita per QALY. The costs of care for the nine different cancers were less than 1 GDP per capita per QALY, with those of lung, esophagus, and liver cancers being the highest. Sensitivity analysis showed the same conclusion. Lifetime risks of six out of nine cancer sites show an increased trend. Conclusion Cancer care in Taiwan seemed cost effective compared with that of other illnesses, but prevention is necessary to make the National Health Insurance more sustainable.",
author = "Hung, {Mei Chuan} and Wu-Wei Lai and Chen, {Helen H.W} and Jenq-Chang Lee and Yih-Jyh Lin and Jenn-Ren Hsiao and Ya-Min Cheng and Yan-Shen Shan and Wu-Chou Su and Jung-Der Wang",
year = "2016",
month = "8",
day = "1",
doi = "10.1016/j.jfma.2016.04.002",
language = "English",
volume = "115",
pages = "609--618",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Excerpta Medica Asia Ltd.",
number = "8",

}

TY - JOUR

T1 - Cost effectiveness of cancer treatment in Taiwan

AU - Hung, Mei Chuan

AU - Lai, Wu-Wei

AU - Chen, Helen H.W

AU - Lee, Jenq-Chang

AU - Lin, Yih-Jyh

AU - Hsiao, Jenn-Ren

AU - Cheng, Ya-Min

AU - Shan, Yan-Shen

AU - Su, Wu-Chou

AU - Wang, Jung-Der

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background/Purpose This study aims to examine the cost effectiveness of treating major cancers compared with other major illnesses in Taiwan. Methods We collected data on 395,330 patients with cancer, 125,277 patients with end-stage renal disease, and 50,481 patients under prolonged mechanical ventilation during 1998–2007. They were followed for 10–13 years to estimate lifetime survival functions using a semiparametric method. EuroQol five-dimension was used to measure the quality of life for 6189 cancer patients and 1401 patients with other illnesses. The mean utility values and healthcare costs reimbursed by the National Health Insurance were multiplied with the corresponding survival probabilities to estimate quality-adjusted life expectancies and lifetime costs, respectively. Data of 22,344 cancer patients under hospice care (considered as a comparison group) were used to conduct a cost-effectiveness analysis. Sensitivity analysis was conducted by assuming patients without treatment survived for 2 years with a quality of life value of 0.5. Results The costs of care for patients under prolonged mechanical ventilation and those with end-stage renal disease were US$41,780–53,708 per quality-adjusted life year (QALY) and US$18,222–18,465 per QALY, respectively, which are equivalent to 2.17–2.79 gross domestic product (GDP) per capita per QALY and 1.18–1.25 GDP per capita per QALY. The costs of care for the nine different cancers were less than 1 GDP per capita per QALY, with those of lung, esophagus, and liver cancers being the highest. Sensitivity analysis showed the same conclusion. Lifetime risks of six out of nine cancer sites show an increased trend. Conclusion Cancer care in Taiwan seemed cost effective compared with that of other illnesses, but prevention is necessary to make the National Health Insurance more sustainable.

AB - Background/Purpose This study aims to examine the cost effectiveness of treating major cancers compared with other major illnesses in Taiwan. Methods We collected data on 395,330 patients with cancer, 125,277 patients with end-stage renal disease, and 50,481 patients under prolonged mechanical ventilation during 1998–2007. They were followed for 10–13 years to estimate lifetime survival functions using a semiparametric method. EuroQol five-dimension was used to measure the quality of life for 6189 cancer patients and 1401 patients with other illnesses. The mean utility values and healthcare costs reimbursed by the National Health Insurance were multiplied with the corresponding survival probabilities to estimate quality-adjusted life expectancies and lifetime costs, respectively. Data of 22,344 cancer patients under hospice care (considered as a comparison group) were used to conduct a cost-effectiveness analysis. Sensitivity analysis was conducted by assuming patients without treatment survived for 2 years with a quality of life value of 0.5. Results The costs of care for patients under prolonged mechanical ventilation and those with end-stage renal disease were US$41,780–53,708 per quality-adjusted life year (QALY) and US$18,222–18,465 per QALY, respectively, which are equivalent to 2.17–2.79 gross domestic product (GDP) per capita per QALY and 1.18–1.25 GDP per capita per QALY. The costs of care for the nine different cancers were less than 1 GDP per capita per QALY, with those of lung, esophagus, and liver cancers being the highest. Sensitivity analysis showed the same conclusion. Lifetime risks of six out of nine cancer sites show an increased trend. Conclusion Cancer care in Taiwan seemed cost effective compared with that of other illnesses, but prevention is necessary to make the National Health Insurance more sustainable.

UR - http://www.scopus.com/inward/record.url?scp=84991045255&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84991045255&partnerID=8YFLogxK

U2 - 10.1016/j.jfma.2016.04.002

DO - 10.1016/j.jfma.2016.04.002

M3 - Article

C2 - 27302557

AN - SCOPUS:84991045255

VL - 115

SP - 609

EP - 618

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 8

ER -