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Cost-Effectiveness of Aspirin, Celecoxib, and Calcium Chemoprevention for Colorectal Cancer

Abstract Background Studies have indicated that aspirin chemoprevention may be effective in preventing colorectal cancer within the general population, and aspirin, celecoxib, and calcium may be effective in preventing adenomas within those people who have previously undergone polypectomy. Objective... Full description

Journal Title: Clinical therapeutics 2011, Vol.33 (9), p.1289-1305
Main Author: Squires, Hazel, MSc
Other Authors: Tappenden, Paul, PhD , Cooper, Katy, PhD , Carroll, Christopher, PhD , Logan, Richard, MB, FRCP , Hind, Daniel, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Bridgewater, NJ: EM Inc USA
ID: ISSN: 0149-2918
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title: Cost-Effectiveness of Aspirin, Celecoxib, and Calcium Chemoprevention for Colorectal Cancer
format: Article
creator:
  • Squires, Hazel, MSc
  • Tappenden, Paul, PhD
  • Cooper, Katy, PhD
  • Carroll, Christopher, PhD
  • Logan, Richard, MB, FRCP
  • Hind, Daniel, PhD
subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis inhibitors
  • Anticarcinogenic Agents - administration & dosage
  • Anticarcinogenic Agents - economics
  • Anticarcinogenic Agents - therapeutic use
  • Aspirin
  • Biological and medical sciences
  • calcium
  • Calcium - administration & dosage
  • Calcium - economics
  • Calcium - therapeutic use
  • Cancer
  • Care and treatment
  • Celecoxib
  • chemoprevention
  • Colorectal cancer
  • Colorectal Neoplasms - diagnosis
  • Colorectal Neoplasms - economics
  • Colorectal Neoplasms - prevention & control
  • Cost-Benefit Analysis
  • Gastroenterology. Liver. Pancreas. Abdomen
  • health economics
  • Humans
  • Internal Medicine
  • Medical Education
  • Medical sciences
  • Middle Aged
  • Models, Economic
  • Occult Blood
  • Oncology, Experimental
  • Pharmacology. Drug treatments
  • Prevention
  • Pyrazoles - administration & dosage
  • Pyrazoles - economics
  • Pyrazoles - therapeutic use
  • Quality-Adjusted Life Years
  • screening
  • Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
  • Sulfonamides - administration & dosage
  • Sulfonamides - economics
  • Sulfonamides - therapeutic use
  • Tumors
  • United Kingdom
ispartof: Clinical therapeutics, 2011, Vol.33 (9), p.1289-1305
description: Abstract Background Studies have indicated that aspirin chemoprevention may be effective in preventing colorectal cancer within the general population, and aspirin, celecoxib, and calcium may be effective in preventing adenomas within those people who have previously undergone polypectomy. Objective To assess the cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention in the context of the fecal occult blood test screening program. Methods An existing state transition model developed to assess colorectal cancer screening options was modified to incorporate the costs and outcomes associated with chemoprevention. Relative risks of disease progression were incorporated based on the effectiveness of the chemopreventive agents. Additional benefits and harms associated with chemoprevention were included. Sensitivity analyses were undertaken. Results Aspirin chemoprevention plus screening within the general population aged 50 to 60 years is estimated to cost £23,000 per quality-adjusted life year (QALY) gained compared with screening alone (based on 2008 prices). For individuals who have undergone polypectomy, calcium is estimated to cost between £8000 and £30,000 per QALY gained depending on the starting and stopping age of the chemoprevention policy. Based on current evidence, calcium has a higher probability than aspirin of providing value for money within this population, although the long-term benefits and harms are subject to considerable uncertainty. Celecoxib chemoprevention is unlikely to be considered to be cost-effective. Conclusion Calcium chemoprevention is likely to be a cost-effective option for individuals who have undergone polypectomy. Further research is required to assess the long-term benefits and harms of calcium compared with aspirin chemoprevention. Chemoprevention appears less economically attractive within the general population.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0149-2918
fulltext: fulltext
issn:
  • 0149-2918
  • 1879-114X
url: Link


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titleCost-Effectiveness of Aspirin, Celecoxib, and Calcium Chemoprevention for Colorectal Cancer
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creatorSquires, Hazel, MSc ; Tappenden, Paul, PhD ; Cooper, Katy, PhD ; Carroll, Christopher, PhD ; Logan, Richard, MB, FRCP ; Hind, Daniel, PhD
creatorcontribSquires, Hazel, MSc ; Tappenden, Paul, PhD ; Cooper, Katy, PhD ; Carroll, Christopher, PhD ; Logan, Richard, MB, FRCP ; Hind, Daniel, PhD
descriptionAbstract Background Studies have indicated that aspirin chemoprevention may be effective in preventing colorectal cancer within the general population, and aspirin, celecoxib, and calcium may be effective in preventing adenomas within those people who have previously undergone polypectomy. Objective To assess the cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention in the context of the fecal occult blood test screening program. Methods An existing state transition model developed to assess colorectal cancer screening options was modified to incorporate the costs and outcomes associated with chemoprevention. Relative risks of disease progression were incorporated based on the effectiveness of the chemopreventive agents. Additional benefits and harms associated with chemoprevention were included. Sensitivity analyses were undertaken. Results Aspirin chemoprevention plus screening within the general population aged 50 to 60 years is estimated to cost £23,000 per quality-adjusted life year (QALY) gained compared with screening alone (based on 2008 prices). For individuals who have undergone polypectomy, calcium is estimated to cost between £8000 and £30,000 per QALY gained depending on the starting and stopping age of the chemoprevention policy. Based on current evidence, calcium has a higher probability than aspirin of providing value for money within this population, although the long-term benefits and harms are subject to considerable uncertainty. Celecoxib chemoprevention is unlikely to be considered to be cost-effective. Conclusion Calcium chemoprevention is likely to be a cost-effective option for individuals who have undergone polypectomy. Further research is required to assess the long-term benefits and harms of calcium compared with aspirin chemoprevention. Chemoprevention appears less economically attractive within the general population.
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languageeng
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subjectAdult ; Aged ; Aged, 80 and over ; Angiogenesis inhibitors ; Anticarcinogenic Agents - administration & dosage ; Anticarcinogenic Agents - economics ; Anticarcinogenic Agents - therapeutic use ; Aspirin ; Biological and medical sciences ; calcium ; Calcium - administration & dosage ; Calcium - economics ; Calcium - therapeutic use ; Cancer ; Care and treatment ; Celecoxib ; chemoprevention ; Colorectal cancer ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - economics ; Colorectal Neoplasms - prevention & control ; Cost-Benefit Analysis ; Gastroenterology. Liver. Pancreas. Abdomen ; health economics ; Humans ; Internal Medicine ; Medical Education ; Medical sciences ; Middle Aged ; Models, Economic ; Occult Blood ; Oncology, Experimental ; Pharmacology. Drug treatments ; Prevention ; Pyrazoles - administration & dosage ; Pyrazoles - economics ; Pyrazoles - therapeutic use ; Quality-Adjusted Life Years ; screening ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Sulfonamides - administration & dosage ; Sulfonamides - economics ; Sulfonamides - therapeutic use ; Tumors ; United Kingdom
ispartofClinical therapeutics, 2011, Vol.33 (9), p.1289-1305
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descriptionAbstract Background Studies have indicated that aspirin chemoprevention may be effective in preventing colorectal cancer within the general population, and aspirin, celecoxib, and calcium may be effective in preventing adenomas within those people who have previously undergone polypectomy. Objective To assess the cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention in the context of the fecal occult blood test screening program. Methods An existing state transition model developed to assess colorectal cancer screening options was modified to incorporate the costs and outcomes associated with chemoprevention. Relative risks of disease progression were incorporated based on the effectiveness of the chemopreventive agents. Additional benefits and harms associated with chemoprevention were included. Sensitivity analyses were undertaken. Results Aspirin chemoprevention plus screening within the general population aged 50 to 60 years is estimated to cost £23,000 per quality-adjusted life year (QALY) gained compared with screening alone (based on 2008 prices). For individuals who have undergone polypectomy, calcium is estimated to cost between £8000 and £30,000 per QALY gained depending on the starting and stopping age of the chemoprevention policy. Based on current evidence, calcium has a higher probability than aspirin of providing value for money within this population, although the long-term benefits and harms are subject to considerable uncertainty. Celecoxib chemoprevention is unlikely to be considered to be cost-effective. Conclusion Calcium chemoprevention is likely to be a cost-effective option for individuals who have undergone polypectomy. Further research is required to assess the long-term benefits and harms of calcium compared with aspirin chemoprevention. Chemoprevention appears less economically attractive within the general population.
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4Anticarcinogenic Agents - administration & dosage
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18Colorectal Neoplasms - diagnosis
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21Cost-Benefit Analysis
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23health economics
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26Medical Education
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abstractAbstract Background Studies have indicated that aspirin chemoprevention may be effective in preventing colorectal cancer within the general population, and aspirin, celecoxib, and calcium may be effective in preventing adenomas within those people who have previously undergone polypectomy. Objective To assess the cost-effectiveness of aspirin, celecoxib, and calcium chemoprevention in the context of the fecal occult blood test screening program. Methods An existing state transition model developed to assess colorectal cancer screening options was modified to incorporate the costs and outcomes associated with chemoprevention. Relative risks of disease progression were incorporated based on the effectiveness of the chemopreventive agents. Additional benefits and harms associated with chemoprevention were included. Sensitivity analyses were undertaken. Results Aspirin chemoprevention plus screening within the general population aged 50 to 60 years is estimated to cost £23,000 per quality-adjusted life year (QALY) gained compared with screening alone (based on 2008 prices). For individuals who have undergone polypectomy, calcium is estimated to cost between £8000 and £30,000 per QALY gained depending on the starting and stopping age of the chemoprevention policy. Based on current evidence, calcium has a higher probability than aspirin of providing value for money within this population, although the long-term benefits and harms are subject to considerable uncertainty. Celecoxib chemoprevention is unlikely to be considered to be cost-effective. Conclusion Calcium chemoprevention is likely to be a cost-effective option for individuals who have undergone polypectomy. Further research is required to assess the long-term benefits and harms of calcium compared with aspirin chemoprevention. Chemoprevention appears less economically attractive within the general population.
copBridgewater, NJ
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pmid21840057
doi10.1016/j.clinthera.2011.07.009