HSRAANZ 2019 Awards – Highly Commended PhD Paper – Michelle Tew



This study was part of a wider program which included a clinical study involving the successful implementation of a nurse-led clinical sepsis pathway for cancer patients at the Peter MacCallum Cancer Centre.

Up to 45% of cancer patients are affected by infection and sepsis, which are associated with significant morbidity, mortality and healthcare utilisation. With the pathway in place, patients with sepsis were identified and treated promptly thus reducing the high mortality rate associated with sepsis.

This study was an economic evaluation to demonstrate the cost-effectiveness of implementing the pathway therefore contributing to the evidence base to inform decision-makers regarding the value of implementing the pathway. The evaluation was conducted using a lifetime decision-analytic model which was able to capture the short-term effects of improved 30-day mortality as measured in the clinical study and long-term consequences in terms of both costs and effectiveness of improved survival of cancer patients extrapolated using a Markov model.

Alongside the evaluation, the study also investigated the impact of including future medical costs, particularly costs unrelated to the intervention being evaluated, in cost-effectiveness analyses. The impact of capturing future medical costs is likely to be particularly important in patients with cancer where costly lifelong medical care is necessary. The lack of clear, definitive pharmacoeconomic guidelines can limit comparability and can impact on cost-effectiveness results used to support decision-makers' considerations relating to future healthcare budgets.

The study was able to demonstrate the practicability of including future medical costs using publicly available data and the importance of capturing existing heterogeneity between cancer types which can give rise to different cost-effectiveness results. This provides important input into treatment, planning and policy decisions.

For further information please see article "Incorporating Future Medical Costs: Impact on Cost-Effectiveness Analysis in Cancer Patients" published in Pharmacoeconomics. https://doi.org/10.1007/s40273-019-00790-9