Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment

Lionel Perrier, Nicola Cautela, Magali Morelle (), Nathalie Havet (), Françoise Ducimetière, Antoine Lurkin (), Jean-Yves Blay (), Pierre Biron, Dominique Ranchère-Vince, Anne-Valérie Decouvelaere, Philippe Thiesse, Christophe Bergeron, François Gilly, Guy de Laroche, Dominic Cellier, Mathieu Laramas, Thierry Philip and Isabelle Ray-Coquard ()
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Nicola Cautela: Université de Lyon, LEFI - Laboratoire d'Economie de la Firme et des Institutions - UL2 - Université Lumière - Lyon 2
Magali Morelle: Université de Lyon, Centre Léon Bérard [Lyon], GATE - Groupe d'analyse et de théorie économique - UL2 - Université Lumière - Lyon 2 - ENS LSH - Ecole Normale Supérieure Lettres et Sciences Humaines - CNRS - Centre National de la Recherche Scientifique
Françoise Ducimetière: Université de Lyon, Centre Léon Bérard [Lyon]
Antoine Lurkin: Université de Lyon, SIS - Santé Individu Société - UL2 - Université Lumière - Lyon 2 - UJML - Université Jean Moulin - Lyon 3 - Université de Lyon - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - HCL - Hospices Civils de Lyon - UJM - Université Jean Monnet - Saint-Étienne - INSERM - Institut National de la Santé et de la Recherche Médicale
Jean-Yves Blay: Université de Lyon, Oncogénèse et progression tumorale - Centre Léon Bérard [Lyon] - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - INSERM - Institut National de la Santé et de la Recherche Médicale
Pierre Biron: Université de Lyon, Centre Léon Bérard [Lyon]
Dominique Ranchère-Vince: Université de Lyon, Centre Léon Bérard [Lyon]
Anne-Valérie Decouvelaere: Université de Lyon, Centre Léon Bérard [Lyon]
Philippe Thiesse: Université de Lyon, Centre Léon Bérard [Lyon]
Christophe Bergeron: Université de Lyon, Centre Léon Bérard [Lyon]
François Gilly: Université de Lyon, CHLS - Centre Hospitalier Lyon Sud [CHU - HCL] - HCL - Hospices Civils de Lyon
Guy de Laroche: Institut de Cancérologie de la Loire Lucien Neuwirth - CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
Dominic Cellier: Merck Santé - Lyon - Merck & Co. Inc - Merck Sharp and Dohme
Mathieu Laramas: CHU de Grenoble - Centre hospitalier universitaire de Grenoble - CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
Thierry Philip: Université de Lyon, Centre Léon Bérard [Lyon]
Isabelle Ray-Coquard: Université de Lyon, SIS - Santé Individu Société - UL2 - Université Lumière - Lyon 2 - UJML - Université Jean Moulin - Lyon 3 - Université de Lyon - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - HCL - Hospices Civils de Lyon - UJM - Université Jean Monnet - Saint-Étienne - INSERM - Institut National de la Santé et de la Recherche Médicale

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Abstract: Background: The impact of compliance to clinical practice guidelines (CPG) on outcomes and/or costs of care has not been completely clarified.Objective: To estimate relationships between medical expenditures and compliance to CPG for initial sarcoma treatment.Research design: Selected cohorts of patients diagnosed with sarcoma in 2005 and 2006, and treated at the University hospital and/or the cancer centre of the Rhône-Alpes region, France (n=90). Main outcome measurements were: patient characteristics, compliance with CPG, health outcomes, and costs. Data were mainly extracted from patient records. The logarithm of treatment costs was modelled using linear and Tobit regressions.Results: Rates of compliance with CPG were 86%, 66%, 88%, 89%, and 95% for initial diagnosis, primary surgical excision, wide surgical excision, chemotherapy, and radiotherapy, respectively. Total average costs reached €24,439, with €1,784, €11,225, €10,360, and €1,016 for diagnosis, surgery (primary and wide surgical excisions), chemotherapy, and radiotherapy, respectively. Compliance of diagnosis with CPG decreased the cost of diagnosis, whereas compliance of primary surgical excision increased the cost of chemotherapy. Compliance of chemotherapy with CPG decreased the cost of radiotherapy.Conclusion: Since chemotherapy is one of the major cost drivers, these results support that compliance with guidelines increases medical care expenditures in short term.

Keywords: Oncology; Sarcoma; Cost; Clinical guidelines; Efficacy; Medical Practices; Government Policy; Regulation; Public Health (search for similar items in EconPapers)
Date: 2008
Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-00322614
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Published in 2008

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Working Paper: Short-Term cost impact of compliance with clinical practice guidelines for initial sarcoma treatment (2008)
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