Skip to main content

Can we maximize both value and quality in gynecologic cancer care? A work in progress.

Publication ,  Journal Article
Havrilesky, LJ; Fountain, C
Published in: Am Soc Clin Oncol Educ Book
2014

Value is defined as desirable health outcomes achieved per monetary unit spent. Comparative effectiveness research and cost-effectiveness research are methods that have been developed to quantify effectiveness and value to inform management decisions. In this article we review the comparative and cost-effectiveness literature in the field of ovarian cancer treatment. Studies have shown that improved ovarian cancer survival is associated with complete primary surgical cytoreduction, with treatment at high volume facilities by subspecialist providers (gynecologic oncologists) and with National Comprehensive Cancer Network (NCCN) guideline-adherent care in both surgical staging and chemotherapy regimens. Intraperitoneal/intravenous chemotherapy (compared with intravenous alone) has been associated with improved survival and cost-effectiveness. Bevacizumab for primary and maintenance therapy has been found to not be cost-effective (even in selective subsets) despite a small progression-free survival (PFS) advantage. For platinum-sensitive recurrent ovarian cancer, secondary cytoreduction and platinum-based combinations are associated with improved overall survival (OS); several platinum-based combinations have also been found cost-effective. For platinum-resistant recurrence, single agent therapy and supportive care are cost-effective compared with combination therapies. Although little prospective clinical research has been done around end-of-life care, one study reported that for platinum-resistant ovarian cancer, palliative intervention would potentially reduce costs and increase quality adjusted life years compared with usual care (based on improvement in quality of life [QOL]). Overall, cost comparisons of individual chemotherapy regimens are highly dependent on market prices of novel therapeutic agents.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Soc Clin Oncol Educ Book

DOI

EISSN

1548-8756

Publication Date

2014

Start / End Page

e268 / e275

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ovarian Neoplasms
  • Humans
  • Female
  • Cytoreduction Surgical Procedures
  • Cost-Benefit Analysis
  • Antineoplastic Agents
  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Havrilesky, L. J., & Fountain, C. (2014). Can we maximize both value and quality in gynecologic cancer care? A work in progress. Am Soc Clin Oncol Educ Book, e268–e275. https://doi.org/10.14694/EdBook_AM.2014.34.e268
Havrilesky, Laura J., and Cynthia Fountain. “Can we maximize both value and quality in gynecologic cancer care? A work in progress.Am Soc Clin Oncol Educ Book, 2014, e268–75. https://doi.org/10.14694/EdBook_AM.2014.34.e268.
Havrilesky LJ, Fountain C. Can we maximize both value and quality in gynecologic cancer care? A work in progress. Am Soc Clin Oncol Educ Book. 2014;e268–75.
Havrilesky, Laura J., and Cynthia Fountain. “Can we maximize both value and quality in gynecologic cancer care? A work in progress.Am Soc Clin Oncol Educ Book, 2014, pp. e268–75. Pubmed, doi:10.14694/EdBook_AM.2014.34.e268.
Havrilesky LJ, Fountain C. Can we maximize both value and quality in gynecologic cancer care? A work in progress. Am Soc Clin Oncol Educ Book. 2014;e268–e275.

Published In

Am Soc Clin Oncol Educ Book

DOI

EISSN

1548-8756

Publication Date

2014

Start / End Page

e268 / e275

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ovarian Neoplasms
  • Humans
  • Female
  • Cytoreduction Surgical Procedures
  • Cost-Benefit Analysis
  • Antineoplastic Agents
  • 3211 Oncology and carcinogenesis