Recent Publications
The socioeconomic impact of cancer on patients and their relatives: Organisation of European Cancer Institute task force consensus recommendations on conceptual framework, taxonomy, and research directions
Cancer patients and their families face significant financial burden, even in high-income countries. These burdens include loss of income and out-of-pocket expenses, which extend beyond the patients to affect their caregivers and dependents. The Organisation of European Cancer Institutes (OECI) task force, recognizing the fragmented and inconsistent research in this area, developed 25 recommendations aimed at establishing a comprehensive definition of socioeconomic impact, a conceptual framework, and a consistent taxonomy to guide future research.
The task force emphasized the need to explore the severity and predictors of financial vulnerability among cancer patients, proposing a neutral term, "socioeconomic impact," to encompass the broad range of effects beyond just financial toxicity. They highlighted the inadequacy of traditional health-related quality-of-life measures to capture these impacts and stressed the importance of developing new patient-reported outcome instruments. The consensus statement underscores the importance of understanding the full scope of the socioeconomic impact of cancer, aiming to provide a reference point for policy development and further research in this area.
M. Schlander, W. van Harten, V. P. Retèl, P. D. Pham, J. M. Vancoppenolle, J. Ubels, O. S. López, C. Quirland, F. Maza, E. Aas, B. Crusius, A. Escobedo, N. Franzen, J. Fuentes-Cid, D. Hernandez, K. Hernandez-Villafuerte, I. Kirac, A. Paty, T. Philip , S. Smeland, R. Sullivan, E. Vanni, S. Varga, T. Vermeulin, R. D. Eckford:
The socioeconomic impact of cancer on patients and their relatives: Organisation of European Cancer Institutes task force consensus recommendations on conceptual framework, taxonomy, and research directions.
The Lancet Oncology, 2024: 25(4) e152-e163.
DOI: 10.1016/S1470-2045(23)00636-8.
Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations
A universally acceptable quality appraisal (QA) tool specific to systematic reviews of studies eliciting Health State Utility Values (HSUVs) is lacking—this study aimed to develop such an instrument and fill this gap. Given the increasing importance of HSUVs in cost-utility analyses, the study emphasizes the need for a robust and tailored QA tool. The study employs a modified Delphi method, involving a panel of seven international experts who participated in two anonymous survey rounds followed by a virtual face-to-face meeting. This process led to the establishment of consensus on the definitions, dimensions, and scope of a QA tool specific to studies eliciting HSUVs, focusing on three primary dimensions: reporting quality, relevance, and methodological quality.
The results showed high response rates and culminated in a consensus on defining scientific quality and QA. The experts agreed on the importance of evaluating all three QA dimensions—reporting, relevance, and methodological quality—to ensure a comprehensive assessment. The study highlights the need for these dimensions to address different aspects of the studies, ensuring their applicability and reliability. It concludes that achieving this consensus marks a significant step towards developing a standardized QA tool that can be used in future systematic reviews of HSUVs. This tool aims to enhance evidence-based healthcare decision-making by providing a consistent, transparent, and reproducible QA framework. Future research will focus on identifying specific QA items and developing detailed guidelines for the tool's application.
M. T. Muchadeyi, K. Hernandez-Villafuerte, G. L. Di Tanna, R. D. Eckford, Y. Feng, M. Meregaglia, T. Peasgood, S. Petrou, J. Ubels, M. Schlander:
Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations.
Pharmacoeconomics: published online 29 March 2024.
DOI: 10.1007/s40273-024-01365-z.
Would initiating colorectal cancer screening from age of 45 be cost-effective in Germany? An individual-level simulation analysis
The study explores the impact of lowering the starting age for colorectal cancer (CRC) screening from 50 to 45 years in Germany, prompted by the rising incidence of early-onset CRC. Utilizing DECAS, an individual-level simulation model, the research assesses the cost-effectiveness of various screening strategies, including colonoscopy every 10 years, annual or biennial fecal immunochemical tests (FIT), or a combination of both. With a cohort of 100,000 individuals with average CRC risk, the simulation examines CRC cases averted, prevented death, quality-adjusted life-years gained (QALYG), and total incremental costs considering both CRC treatment and screening costs.
The findings indicate that starting CRC screening at age 45, through either colonoscopy every 10 years alone or in combination with FIT, results in incremental gains of QALYs between 7 and 28, with incremental costs ranging from €28,360 to €71,759 per 1,000 individuals, compared to the current strategy. The Incremental Cost-Effectiveness Ratio (ICER) ranged between €1,029 and €9,763 per QALYG, with the additional number of colonoscopies needed varying from 129 to 885 per 1,000 individuals. The most effective strategy was identified as undergoing colonoscopy three times, starting age 45, while FIT alone was less effective than the current standard. These findings highlight the economic and health benefits of earlier CRC screening, advocating for an inclusion of younger individuals in screening programs.
M. W. Lwin, C.-Y. Cheng, S. Calderazzo, C. Schramm, M. Schlande:
Would initiating colorectal cancer screening from age of 45 be cost-effective in Germany? An individual-level simulation analysis.
Frontiers in Public Health, published online 2024 Feb 21: Article12:1307427.
DOI: 10.3389/fpubh.2024.1307427.
Recent Presentations
The ISPOR Europe 2023 conference, which took place November 12-15, 2023 in Copenhagen, provided an opportunity for members of our team to present some of their ongoing work. Among the highlights, Ramon Schaefer received the Best General Poster Research Presentation, and Muchandifunga Muchadeyi was among the Spotlight Poster Presenters. Below, you will find the full listing of the published abstracts.
M. Schlander, D. Hernandez, O. Schwarz, R. Schaefer: What Is a Year of Life Worth? Empirical Findings from Worldwide Economic Studies on the Value of a Statistical Life.
M. Muchadeyi, S. Hao, K. Hernandez-Villafuerte, S. Khan, P. Albers, M. Schlander, M. Clements: Cost-Effectiveness Analysis of Prostate-Specific Antigen-Based Risk-Adapted Screening in Germany: An Early Economic Evaluation Study.
M.W. Lwin, C.-Y. Cheng, S. Calderazzo, C. Schramm, M. Schlander: Would Initiating Colorectal Cancer Screening from Age 45 be Cost-Effective in Germany? An Individual-Level Simulation Analysis.
P. D. Pham, J. Ubels, M. Schlander: Measuring the Socioeconomic Impact of Cancer: A Systematic Review and Standardized Assessment of Patient-Reported Outcome (PRO) Instruments.
M. Muchadeyi, K. Hernandez-Villafuerte, G. Di Tanna, R. Eckford, Y. Feng, M. Meregaglia, T. Peasgood, S. Petrou, J. Ubels, M. Schlander: Development of a Quality Appraisal Tool for Systematic Literature Reviews of Studies Eliciting Health State Utility Values (HSUVs): A Modified-Delphi Consensus Approach.
Cancer Core Europe and DART
DKFZ Division of Health Economics is involved in the international Cancer Core Europe (CCE) consortium to collaborate on the DART project. The project has received funding from the European Union´s Horizon 2020 research and innovation programme under grant agreement No 965397.
For further information please visit the CCE-DART website: https://cce-dart.com/
Building Data Rich Clinical Trials (CCE- DART): Cancer research is rapidly evolving with the proliferation of molecular targeted therapies. New clinical trial designs including adaptive, basket, and umbrella trials, have been developed to assess innovative treatments tied to the existence of selected biomarkers rather than histological site. Clinical trials are the best source of clinical evidence but current studies still are too rigid and have too many limitations that do not allow them to adapt to the speed of the discoveries in oncology. The project aims to improve the design and implementation of clinical trials, and the use of newer, more effective methods. The Division of Health Economics contributes to the research project by investigating how clinical data from new trial designs can be incorporated in health economic evaluations to ensure validity of outcomes. The project is ideal to implement state-of-the-art health economic methods for cost-effectiveness analyses to assess the health care impact of molecular targeted therapies.
How to work with us
If any of our areas of research are of interest (see: What we do) and you would like to pursue a PhD or master's degree in our department, please contact Katrin Eike-Verfürth at k.eike-verfuerth@dkfz-heidelberg.de