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A clinical decision and economic analysis model of cancer pain management.

Publication ,  Journal Article
Abernethy, AP; Samsa, GP; Matchar, DB
Published in: Am J Manag Care
October 2003

OBJECTIVE: To design a model that educates clinical decision makers and healthcare professionals about the burden of cancer pain in their individual populations, and that assists them in weighing the effectiveness and cost of different cancer pain management strategies. STUDY DESIGN: Tailored cost-effectiveness analysis using an evidence-based decision analytic model. METHODS: The spreadsheet-based model compares 3 strategies: (1) guideline-based care (GBC), (2) oncology-based care (OBC), and (3) usual care (UC). The model calculates the likelihood of cancer pain in a healthcare population, how effectively that pain is managed, and the average monthly cost of medications plus procedural interventions. Model inputs were derived from published US population demographics, cancer registry data, high-quality studies of cancer pain management, standard reimbursement schedules, and expert opinion. The model permits users to tailor population demographics, strategy effectiveness, and resource costs. RESULTS: Of 100 000 patients with typical US demographics, approximately 508 (0.51%) will have cancer and 205 (0.20%) will suffer from cancer pain. After 1 month, the percentage of cancer pain patients with effective pain management and the cost of each strategy were estimated as follows: (1) GBC, 80% and dollar 579; (2) OBC, 55% and dollar 466; and (3) UC, 30% and dollar 315. Compared with OBC, GBC had an incremental cost-effectiveness ratio of dollar 452 per additional patient relieved of cancer pain. Compared with UC, OBC had an incremental cost-effectiveness ratio of dollar 601 per additional patient relieved of cancer pain. CONCLUSION: Guideline-based cancer pain management leads to improved pain control with modest increases in resource use.

Duke Scholars

Published In

Am J Manag Care

ISSN

1088-0224

Publication Date

October 2003

Volume

9

Issue

10

Start / End Page

651 / 664

Location

United States

Related Subject Headings

  • United States
  • Probability
  • Practice Guidelines as Topic
  • Palliative Care
  • Pain Management
  • Pain
  • Neoplasms
  • Models, Econometric
  • Humans
  • Health Policy & Services
 

Citation

APA
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ICMJE
MLA
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Abernethy, A. P., Samsa, G. P., & Matchar, D. B. (2003). A clinical decision and economic analysis model of cancer pain management. Am J Manag Care, 9(10), 651–664.
Abernethy, Amy P., Gregory P. Samsa, and David B. Matchar. “A clinical decision and economic analysis model of cancer pain management.Am J Manag Care 9, no. 10 (October 2003): 651–64.
Abernethy AP, Samsa GP, Matchar DB. A clinical decision and economic analysis model of cancer pain management. Am J Manag Care. 2003 Oct;9(10):651–64.
Abernethy, Amy P., et al. “A clinical decision and economic analysis model of cancer pain management.Am J Manag Care, vol. 9, no. 10, Oct. 2003, pp. 651–64.
Abernethy AP, Samsa GP, Matchar DB. A clinical decision and economic analysis model of cancer pain management. Am J Manag Care. 2003 Oct;9(10):651–664.

Published In

Am J Manag Care

ISSN

1088-0224

Publication Date

October 2003

Volume

9

Issue

10

Start / End Page

651 / 664

Location

United States

Related Subject Headings

  • United States
  • Probability
  • Practice Guidelines as Topic
  • Palliative Care
  • Pain Management
  • Pain
  • Neoplasms
  • Models, Econometric
  • Humans
  • Health Policy & Services