Key result
Radiation-induced cardiotoxicity in breast cancer survivors evokes a mean incremental cost of €275.10 and an additional decrement of 0.017 QALYs per woman over 20 years.
Why the study?
While mechanisms of radiation-induced cardiotoxicity are documented, little is known about the societal burden of radiation-induced cardiovascular diseases in breast cancer survivors.
Does radiation-induced cardiotoxicity increase societal costs and disutility in breast cancer survivors?
Does radiation-induced cardiotoxicity increase societal costs and disutility in breast cancer survivors?
Effect estimate: Incremental cost of €275.10 and decrement of 0.017 QALYs
Current radiation techniques for breast cancer result in minor societal costs and disutility from radiation-induced cardiotoxicity, justifying past investments in heart-sparing technologies.
Background and Purpose Radiation-induced cardiotoxicity is an important health concern for clinicians during treatment of breast cancer (BC) patients. Underlying mechanisms are well-documented, whereas little is known about the societal impact of this long-term effect. This study aimed to quantify the additional burden of radiation-induced cardiovascular (CV) diseases in BC survivors. Materials and Methods Conventional health economic modelling techniques were applied to estimate attributed CV-related costs and disutility in a hypothetical cohort of BC survivors. A situation in which radiotherapy caused an additional CV risk was compared with a situation in which this risk was not taken into account. Uncertainty was assessed via deterministic and probabilistic sensitivity analyses. Analyses were performed from a broad societal perspective up until 20 years after BC treatment. Results Radiation-induced cardiotoxicity evokes a mean incremental cost of €275.10 per woman over a time horizon of 20 years after BC treatment. An additional decrement of 0.017 QALYs (per woman) might be expected when taking the radiation-induced cardiotoxic risk into account in BC survivors. Incremental costs and disutility increased with age. A scenario analysis showed that these results were more profound in women with more advanced staging. Conclusion Our analyses suggest that with current radiation techniques, rather minor costs and disutility are to be expected from radiation-induced cardiotoxicity in BC survivors. The cost of past investments in order to achieve current mean heart dose (MHD) seems justified when considering the gains from cost and disutility reduction resulting from radiation-induced cardiovascular events. The question we might consider is whether future opportunity costs associated with investments on further technological advancements offset the expected marginal benefit from further reducing the MHD.
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Kimpe et al. (2022) studied Breast cancer (n=1,000). Radiotherapy (radiation-induced cardiotoxicity) vs. No additional cardiovascular risk from radiotherapy was evaluated on Incremental cost and disutility (QALYs) (Incremental cost of €275.10 and decrement of 0.017 QALYs). Radiation-induced cardiotoxicity in breast cancer survivors evokes a mean incremental cost of €275.10 and an additional decrement of 0.017 QALYs per woman over 20 years.
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