Friday, October 31, 2014

The cost of anal cancer in England: retrospective hospital data analysis and Markov model

Background

Anal cancer requires a multidisciplinary approach to treatment with often complex interventions. Little is known regarding the associated costs and resource use.

Methods

Patient records were extracted from a national hospital database to estimate the number of patients treated for anal cancer in England. Identified resource use was linked to published UK cost estimates to quantify the reimbursement of treatment through the Payment by Results system. A mathematical model was developed simultaneously to validate findings and to calculate the average 10-year cost of treating a squamous cell anal carcinoma case from diagnosis. The model utilised data from the Association of Coloproctology of Great Britain and Ireland's anal cancer position statement.

Results

On average, 1,564 patients were admitted to hospital and 389 attended an outpatient facility per year. The average annual cost per inpatient and outpatient ranged from [pound sign]4,562-[pound sign]5,230 and [pound sign]1,146-[pound sign]1,335, respectively. Based on the model estimates, the inflated cost per case was between [pound sign]16,470-[pound sign]16,652. Results were most sensitive to the mode of admission for primary treatment and the costs of staging/diagnosis (inflated range: [pound sign]14,309-[pound sign]23,264).

Conclusions

Despite limitations in the available data, these results indicate that the cost of treating anal cancer is significant. Further observational work is required in order to verify these findings.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.