An economic model to establish the costs associated with routes to presentation for patients with multiple myeloma in the United Kingdom.
Porteous, Alex Gibson, Scott Eddowes, Lucy A Drayson, Mark Pratt, Guy
Bowcock, Stella Willis, Fenella Parkin, Hannah Renwick, Suzanne Laketic-Ljubojevic, Ira
Porteous, Alex
Gibson, Scott
Eddowes, Lucy A
Drayson, Mark
Bowcock, Stella
Willis, Fenella
Parkin, Hannah
Renwick, Suzanne
Laketic-Ljubojevic, Ira
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2023-02-24
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Abstract
Objectives: Patients with myeloma often face significant diagnostic delay, with up to one-third of UK patients diagnosed after an emergency presentation (EP). Compared with other routes, patients presenting as an emergency have more advanced disease, increased complications, and poorer prognosis.
Methods: An economic model was developed using a decision-tree framework and lifetime time horizon to estimate costs related to different presentation routes (EP, general practitioner [GP] 2-week wait, GP urgent, GP routine, and consultant to consultant) for UK patients diagnosed as having myeloma. After diagnosis, patients received one of 3 first-line management options (observation, active treatment, or end-of-life care). Inputs were derived from UK health technology assessments and targeted literature reviews, or based on authors' clinical experience where data were unavailable. Active treatment, complication, and end-of-life care costs were included.
Results: The average per-patient cost of treating myeloma (across all routes) was estimated at £146 261. The average per-patient cost associated with EP (£152 677) was the highest; differences were minimal compared with GP 2-week wait (£149 631) and consultant to consultant (£147 237). GP urgent (£140 025) and GP routine (£130 212) were associated with marginally lower costs. Complication (£42 252) and end-of-life care (£11 273) costs were numerically higher for EP than other routes (£25 021-£38 170 and £9772-£10 458, respectively).
Conclusions: An economic benefit may be associated with earlier diagnosis, gained via reduced complication and end-of-life care costs. Strategies to expedite myeloma diagnosis and minimize EPs have the potential to improve patient outcomes and may result in long-term savings that could offset any upfront costs associated with their implementation.
Citation
Porteous A, Gibson S, Eddowes LA, Drayson M, Pratt G, Bowcock S, Willis F, Parkin H, Renwick S, Laketic-Ljubojevic I, Howell D, Smith A, Stern S. An Economic Model to Establish the Costs Associated With Routes to Presentation for Patients With Multiple Myeloma in the United Kingdom. Value Health Reg Issues. 2023 May;35:27-33. doi: 10.1016/j.vhri.2023.01.001. Epub 2023 Feb 24
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Article