Expert Centers are Cost-Effective -- MEDICA - World Forum for Medicine

A cost-effectiveness study of a hypothetical cohort of patients with advanced-stage ovarian cancer, performed using decision-analysis modeling, reveals that an expert center can provide significantly longer quality-adjusted survival compared to less experienced centers, leading to a lower cost per quality of life year gained.

The most important prognostic factors in ovarian cancer include the thoroughness of the surgical resection and the compliance with recommended contemporary adjuvant chemotherapy treatment. Interestingly, the medical professional that manages the ovarian cancer patient impacts the quality of each of those factors. Studies have shown that gynecologic oncologists have better outcomes than other surgeons. Furthermore, better outcomes are observed when ovarian cancer patients are managed at a high-volume, multidisciplinary medical centers compared to low-volume medical centers.

Led by Robert E. Bristow, M.D. of the Kelly Gynecologic Oncology Service at the Johns Hopkins Medical Institutions in Baltimore, researchers compared the treatment efficacy, costs, and cost-effectiveness of these two referral strategies in a modelling study.

The researchers discovered that though the overall cost of managing ovarian cancer at an expert center was more ($50,652 versus $39,957), quality of life and survival as measured by quality-adjusted life years (QALYs) were significantly better (5.12 QALYs versus 2.33 QALYs). Cost effectiveness analysis further demonstrated that an expert facility was more cost-effective at only $9,893/QALY at an expert center compared to $17,149/QALY at a less experienced center.; Source: John Wiley & Sons, Inc.