IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0127814.html
   My bibliography  Save this article

Cost-Effectiveness of Proton Beam Therapy for Intraocular Melanoma

Author

Listed:
  • James P Moriarty
  • Bijan J Borah
  • Robert L Foote
  • Jose S Pulido
  • Nilay D Shah

Abstract

Purpose: Proton beam therapy is a commonly accepted treatment for intraocular melanomas, but the literature is lacking in descriptions of patient preferences of clinical outcomes and economic impact. In addition, no economic evaluations have been published regarding the incremental cost-effectiveness of proton beam therapy compared with enucleation or plaque brachytherapy, typical alternative treatments. We, therefore, conducted a cost-utility analysis of these three approaches for the treatment of intraocular melanomas. Materials and Methods: A Markov model was constructed. Model parameters were identified from the published literature and publicly available data sources. Cost-effectiveness of each treatment was calculated in 2011 US Dollars per quality-adjusted life-year. Incremental cost-effectiveness ratios were calculated assuming enucleation as reference. One-way sensitivity analyses were conducted on all model parameters. A decision threshold of $50,000/quality-adjusted life-year was used to determine cost-effectiveness. Results: Enucleation had the lowest costs and quality-adjusted life-years, and plaque brachytherapy had the highest costs and quality-adjusted life-years. Compared with enucleation, the base-case incremental cost-effectiveness ratios for plaque brachytherapy and proton beam therapy were $77,500/quality-adjusted life-year and $106,100/quality-adjusted life-year, respectively. Results were highly sensitive to multiple parameters. All three treatments were considered optimal, and even dominant, depending on the values used for sensitive parameters. Conclusion: Base-case analysis results suggest enucleation to be optimal. However, the optimal choice was not robust to sensitivity analyses and, depending on the assumption, both plaque brachytherapy and proton beam therapy could be considered cost-effective. Future clinical studies should focus on generating further evidence with the greatest parameter uncertainty to inform future cost-effectiveness analyses.

Suggested Citation

  • James P Moriarty & Bijan J Borah & Robert L Foote & Jose S Pulido & Nilay D Shah, 2015. "Cost-Effectiveness of Proton Beam Therapy for Intraocular Melanoma," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0127814
    DOI: 10.1371/journal.pone.0127814
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127814
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0127814&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0127814?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David M. J. Naimark & Michelle Bott & Murray Krahn, 2008. "The Half-Cycle Correction Explained: Two Alternative Pedagogical Approaches," Medical Decision Making, , vol. 28(5), pages 706-712, September.
    2. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    3. Richard A. Hirth & Michael E. Chernew & Edward Miller & A. Mark Fendrick & William G. Weissert, 2000. "Willingness to Pay for a Quality-adjusted Life Year," Medical Decision Making, , vol. 20(3), pages 332-342, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Smith, Richard D. & Richardson, Jeff, 2005. "Can we estimate the `social' value of a QALY?: Four core issues to resolve," Health Policy, Elsevier, vol. 74(1), pages 77-84, September.
    2. Kevin Haninger & James K. Hammitt, 2011. "Diminishing Willingness to Pay per Quality‐Adjusted Life Year: Valuing Acute Foodborne Illness," Risk Analysis, John Wiley & Sons, vol. 31(9), pages 1363-1380, September.
    3. Herrera-Araujo, Daniel & Hammitt, James K. & Rheinberger, Christoph M., 2020. "Theoretical bounds on the value of improved health," Journal of Health Economics, Elsevier, vol. 72(C).
    4. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.
    5. Gandjour, Afschin & Chernyak, Nadja, 2011. "A new prize system for drug innovation," Health Policy, Elsevier, vol. 102(2), pages 170-177.
    6. Kristina Burström & Magnus Johannesson & Finn Diderichsen, 2003. "The value of the change in health in Sweden 1980/81 to 1996/97," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 637-654, August.
    7. John Vernon & Robert Goldberg & Joseph Golec, 2009. "Economic Evaluation and Cost-Effectiveness Thresholds," PharmacoEconomics, Springer, vol. 27(10), pages 797-806, October.
    8. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    9. McCabe, Christopher & Brazier, John & Gilks, Peter & Tsuchiya, Aki & Roberts, Jennifer & O'Hagan, Anthony & Stevens, Katherine, 2006. "Using rank data to estimate health state utility models," Journal of Health Economics, Elsevier, vol. 25(3), pages 418-431, May.
    10. David Mayston, "undated". "Developing a Framework Theory for Assessing the Benefits of Careers Guidance," Discussion Papers 02/08, Department of Economics, University of York.
    11. Scott Johnson & Matthew Davis & Anna Kaltenboeck & Howard Birnbaum & ElizaBeth Grubb & Marcy Tarrants & Andrew Siderowf, 2011. "Early retirement and income loss in patients with early and advanced Parkinson’s disease," Applied Health Economics and Health Policy, Springer, vol. 9(6), pages 367-376, November.
    12. Hoy, Michael & Polborn, Mattias K., 2015. "The value of technology improvements in games with externalities: A fresh look at offsetting behavior," Journal of Public Economics, Elsevier, vol. 131(C), pages 12-20.
    13. Richard D. Smith, 2008. "Contingent valuation in health care: does it matter how the ‘good’ is described?," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 607-617, May.
    14. Richard H. Chapman & Marc Berger & Milton C. Weinstein & Jane C. Weeks & Sue Goldie & Peter J. Neumann, 2004. "When does quality‐adjusting life‐years matter in cost‐effectiveness analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 429-436, May.
    15. Hui Zhang & Christian Wernz & Danny R. Hughes, 2018. "Modeling and designing health care payment innovations for medical imaging," Health Care Management Science, Springer, vol. 21(1), pages 37-51, March.
    16. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    17. Donald S Shepard & Yara A Halasa & Dina M Fonseca & Ary Farajollahi & Sean P Healy & Randy Gaugler & Kristen Bartlett-Healy & Daniel A Strickman & Gary G Clark, 2014. "Economic Evaluation of an Area-Wide Integrated Pest Management Program to Control the Asian Tiger Mosquito in New Jersey," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-11, October.
    18. Mark Sculpher & Amiram Gafni, 2001. "Recognizing diversity in public preferences: The use of preference sub‐groups in cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 317-324, June.
    19. Cookson, Richard, 2000. "Incorporating psycho-social considerations into health valuation: an experimental study," Journal of Health Economics, Elsevier, vol. 19(3), pages 369-401, May.
    20. Franz Hessel & Christoph Wegner & Johannes Müller & Christina Glaveris & Jürgen Wasem, 2004. "Economic evaluation and survival analysis of immunoglobulin adsorption in patients with idiopathic dilated cardiomyopathy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(1), pages 58-63, February.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0127814. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.