Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/56154
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Type: Journal article
Title: Costing the components of pain management. Analysis of Trans-Tasman Radiation Oncology Group trial (TROG 96.05): One versus five fractions for neuropathic bone pain
Author: Pollicino, C.
Turner, S.
Roos, D.
O'Brien, P.
Citation: Radiotherapy and Oncology, 2005; 76(3):264-269
Publisher: Elsevier Sci Ireland Ltd
Issue Date: 2005
ISSN: 0167-8140
1879-0887
Statement of
Responsibility: 
Christine A. Pollicino, Sandra L. Turner, Daniel E. Roos, and Peter C. O'Brien
Abstract: <h4>Background and purpose</h4>Bone metastases causing neuropathic pain (NBP) have traditionally been treated with fractionated radiotherapy (RT). A recently reported randomised Trans-Tasman Radiation Oncology Group trial (TROG 96.05) supports this approach in many cases [Roos DE, Turner SL, O'Brien PC et al. Randomised trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05). Radiother Oncol 2005;75:54-63]. This study sought to compare costs to the Australian health-care system for patients receiving 1 versus 5 fractions for NBP.<h4>Patients and methods</h4>The RT and medication costs for 245 patients treated on TROG 96.05 were determined from trial data out to 3 months from RT. Admission costs and causes were derived from hospital records.<h4>Results</h4>RT costs (including re-treatments) were calculated to be 222 and 724 Australian dollars (A dollars) per patient for the 8 Gy/1 and 20 Gy/5 arms, respectively. This difference increased when analgesics (A dollars 192 versus A dollars 229) and related hospital admissions (A dollars 1,411 versus A dollars 1,893) were considered. Sensitivity analysis demonstrated an incremental cost saving of between A dollars 795 and A dollars 1,468 for single fraction RT. Admission rates had the strongest potential to distort cost differences.<h4>Conclusions</h4>Clinical outcomes are paramount in choice of fractionation scheme but are optimally considered in the light of economic implications. Overall cost differences between fractionation schedules may vary greatly from those incurred by the RT treatment centre alone. Ideally, such economic evaluations should be planned at the outset of a trial.
Keywords: Cost analysis
Bone metastases
Neuropathic pain
Radiotherapy
Description: Copyright © 2005 Elsevier Ireland Ltd All rights reserved.
DOI: 10.1016/j.radonc.2005.07.003
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