Diagnose und Behandlung von sekundären Armlymphödemen nach Mammakarzinombehandlung

eine gesundheitsökonomische Evaluation aus der Perspektive der Privaten Krankenversicherung

authored by

A. Lange, A. Prenzler, J. M. Von Der Schulenburg

Abstract

Objectives: Secondary arm lymphedema after breast cancer (BC) treatment occurs in approximately 10-20% of all patients. Arm lymphedema are still diagnosed at a late stage, often when symptoms begin to appear and too late for treatment to be effective. New diagnostic tools such as L-Dex 400, which use the bioimpedance spectroscopy (BIS) allow an early diagnosis along with a higher sensitivity and specificity. The objective of this study is therefore to estimate the economic outcomes associated with routine use of L-Dex 400 to aid in the assessment of lymphedema following breast cancer (BC) treatment. Methods: A payer-perspective decision model was built to calculate the 4-year budget impact of using either current standard methods or BIS-aided assessments for lymphedema in post-BC patients among a hypothetical payer population. For this purpose, the costs of diagnosis, the costs of lymphedema treatment, and the cost of possible complications were considered. The assessment was made from the German private health insurance perspective. In addition, a univariate sensitivity analysis was performed. Results: With L-Dex 400 the cost savings from the perspective of the private health insurance totals€57.2 million over the four-year period. The savings are thereby driven by significantly lower treatment costs due to early diagnosis. Results of the sensitivity analysis suggest that the level of specificity of the treatment options, the number of incident patients and the number of medical consultations are the most influential input parameters Conclusions: Over 4 year, BIS-aided assessment of lymphedema for patients following treatment for BC results in cost savings for the private health insurance. Initially higher diagnostic costs are offset by savings in the treatment of lymphedema and possible complications through early diagnosis in a reversible stage.

Organisation(s)

Center for Health Economics Research Hannover (CHERH)

Type

Article

Journal

Gesundheitsokonomie und Qualitatsmanagement

Volume

19

Pages

70-78

No. of pages

9

ISSN

1432-2625

Publication date

04.2014

Publication status

Published

Peer reviewed

Yes

ASJC Scopus subject areas

Health Policy

Sustainable Development Goals

SDG 3 - Good Health and Well-being

Electronic version(s)

https://doi.org/10.1055/s-0033-1335448 (Access: Closed)