Decision modelling of economic evaluation of intervention programme of breast cancer

Authors

  • Jung-Chen Chang PhD,

    1. Associate Professor, Department of Geriatric Health Promotion, College of Healthcare Management, Kainan University, Taoyuan County, Taiwan
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  • Tony H-H. Chen PhD,

    Corresponding author
    1. Professor, Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan, Professor, Centre of Biostatistical Consultation, College of Public Health, National Taiwan University, Taipei, Taiwan and Professor, Tampere School of Public Health, Tampere, Finland
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  • Stephen W. Duffy MS,

    1. Professor, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, London, UK
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  • Amy M-F. Yen PhD,

    1. Research Fellow, Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan and Adjunct Assistant Professor, Centre of Biostatistical Consultation, College of Public Health, National Taiwan University, Taipei, Taiwan
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  • Sam L-S. Chen PhD

    1. Research Fellow, Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan, Research Fellow, Centre of Biostatistical Consultation, College of Public Health, National Taiwan University, Taipei, Taiwan and Deputy Director, Laboratory of Biostatistics, Changhua Christian Hospital, Changhua, Taiwan
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Professor Tony H-H. Chen
Division of Biostatistics
Graduate Institute of Epidemiology
College of Public Health
National Taiwan University
Room 540, no. 17, Hsuchow Rd
Taipei
Taiwan
/Tampere School of Public Health
University of Tampere
Tampere 33520
Finland
E-mail: chenlin@ntu.edu.tw

Abstract

Objectives  Economic appraisal of an intervention is a complex and multivariable problem, with probabilistic issues related not only to clinical outcomes but also to costs and willingness to pay.

Methods  We provide a comprehensive framework for economic appraisal of a health intervention to prevent beast cancer mortality, involving probabilistic model of costs as well as of aspects of the disease process. The economic appraisal can give a range of probabilities of cost-effectiveness depending on willingness or ability to pay.

Results  We apply the method to the example of polychemotherapy for early breast cancer. Results indicate a 30% probability of cost-effectiveness for a willingness to pay of $60 000 per quality-adjusted life-year and around 50% for a threshold of $100 000.

Conclusion  The comprehensive economic appraisal model is a powerful tool for decision making over a range of economic environments.

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