Cost-effectiveness analysis on advanced cervical carcinoma patients at dr mohammad hoesin general hospital palembang, south sumatra, indonesia

Abstract

Introduction: The management of advanced cervical carcinoma still faces many obstacles in developing countries like Indonesia, and this has an impact on the efficacy of treatment and delays in treatment. Objective: To compare the cost-effectiveness on advanced cervical carcinoma management between among patients treated with fully dosed chemotherapy once every in three weeks, and chemoradiation combination therapy in divided doses chemotherapy with radiation every week. Methods: A retrospective study has been done from January to December 2014 at Mohammad Hoesin, General Hospital in Palembang. There were 105 patients newly diagnosed with advanced cervical carcinoma who fulfilled the criteria inclusion and divided into two groups; 66 patients were in the chemotherapy group and 39 patients were in the chemoradiation group. The total cost from diagnosis to treatment was analyzed by using activity-based costing (ABC) and cost-effectiveness ratio (CER) methods between chemotherapy and chemoradiation. Result: This study showed that there were 64.76% of patients revealed a positive reaction to the chemoradiation and 57.57% to the chemotherapy. These differences wsere caused by the price of medical devices (62.48 % for chemotherapy, 67.6628% for chemoradiation). On the other hand, the operational cost for chemotherapy was cheaper than of chemoradiation, 1, 502, 444, 446 IDR and 1, 591, 510, 404 IDR, respectively. The maintenance cost of chemotherapy was lower than the maintenance cost of chemoradiation. The total budget of chemotherapy for cervical carcinoma management (43, 345, 805) was cheaper than of the total budget of chemoradiation therapy (80, 644, 767). The CER for chemoradiation is lower than the CER for chemotherapy in terms of complete, partial or progressive clinical responses. Conclusion: It can be concluded that the use of chemoradiation modality was more effective than the use of chemotherapy.