Researchers study cost-effectiveness of rectal cancer treatments

Costs are on the rise for many types of medical treatments. UCLA researchers are looking for cost-effective ways to treat people with locally advanced rectal cancer, a cancer located in the extreme part of the large intestine.

"There is an urgent need for cost-effective studies in the field of radiation oncology," said Dr. Ann Raldow, first author of the study and a member of the Jonsson Cancer Treatment Center. from UCLA. "As our treatments become more and more technical and expensive, it is incumbent upon us to prove that these treatments provide benefits that justify rising costs and that limited resources are appropriately allocated."

To find the most economical ways to treat this type of cancer, the researchers compared two common treatments, long-term chemoradiotherapy and short-term radiotherapy.

Long-term chemoradiation is currently the standard of care in the United States for the treatment of locally advanced rectal cancer. This treatment requires 28 radiotherapy treatments with chemotherapy. However, outside the United States, as in other European countries, short-course radiotherapy with five treatments is more common. Both treatments are badociated with similar treatment outcomes.

UCLA researchers have developed a mathematical model to evaluate the cost-effectiveness of these two treatments. The model simulated the results over 10 years for hypothetical patients aged 65 years. Hypothetical patients had locally advanced rectal cancer and were treated with one of two treatments. They also underwent surgery and chemotherapy. The researchers supported the costs of the two treatment approaches in the Bluebook Health and Medicare Fee tables, which cover the typical costs of medical treatment in the United States.

The researchers found that with an additional cost-effectiveness ratio of $ 133,495 per quality-adjusted life year, short-term radiotherapy was the most cost-effective treatment compared to long-term chemoradiotherapy. The quality-adjusted life year is a way of measuring the cost-effectiveness of medical treatments taking into account the duration and quality of the patient's life. The differential cost-effectiveness ratio was calculated by dividing the cost difference by the difference in health outcomes of the two approaches.

For patients with distal tumors, tumors close to the anus, long-term chemoradiotherapy was more cost-effective, with an additional cost-effectiveness of $ 61,123 per quality-adjusted life year. The reason this is more cost effective is that long-term chemoradiotherapy may reduce sphincter muscle tumors, which may help avoid surgery that results in a colostomy pouch for life.

The study is published in JAMA Network open now.