Economic evaluation of automated scalp cooling systems for breast cancer patients in Spain
摘要
Different alternatives exist to prevent chemotherapy-induced alopecia (CIA), such as scalp cooling (SC). We conducted an economic evaluation to assess SC systems for breast cancer patients in Spain.
MethodsA decision tree was built to compare automated SC systems (DigniCap® and Paxman) with the usual clinical practice in Spain (not using the SC), over an 18-month time horizon and applying the National Health Service (NHS) and social perspectives. The target population were women diagnosed with breast cancer (stages I and II), undergoing chemotherapy treatment. We estimated the number of women preventing CIA, quality-adjusted life years (QALYs), incremental costs, and the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were performed.
ResultsThe DigniCap® system increased costs by €505.97 and €251.8 (NHS and social perspectives), while the Paxman system did by €176.95 (NHS perspective), compared to not using SC. Both systems could generate 0.03 QALYs more than the usual clinical practice. The ICERs were below the willingness to pay threshold (€25 000 per QALY). Paxman, from the social perspective, represented a cost reduction of €77.22, being less costly and more effective in terms of QALYs. Sensitivity analyses confirmed these results. SC systems prevented CIA in 47% of the target population.
ConclusionsAutomated SC systems could generate a higher cost (except Paxman from the social perspective) and more QALYs compared to the usual clinical practice in Spain. They could be considered cost-effectiveness technologies or a dominant alternative, in the case of Paxman applying a social perspective.