For the cost-utility analysis of colon cancer prevention in patients with ulcerative colitis, Rubenstein and his colleagues created a Markov model, a mathematical simulation of hypothetical patients over time. No real patients were enrolled in this study.
The hypothetical patients consisted of 35-year-old men with an eight year history of ulcerative colitis, which was inactive at the time of enrollment in the study. Using this model, the study followed the cohort until age 90 or until death, whichever occurred first.
To determine if statin chemoprevention is more cost-effective than the current standard of care, the study compared seven strategies for colon cancer prevention, including doing nothing, annual colonoscopy, colonoscopy every five years, statin alone, and statin in combination with colonoscopy annually, every five years or every 10 years.
By age 47, 6.3 percent of patients in the "do nothing" strategy, meaning they did not receive statins or undergo surveillance, developed colon cancer. During the course of their lives, 37.5 percent of patients in this group developed colon cancer and incurred an average cost of $103,801 for care.
While annual surveillance without statin chemoprevention prevented 96 percent of cancers, 57 percent of patients in this group underwent a colectomy, and their lifetime cost for care was $103,348. However, with surveillance every five years, 39 percent of patients underwent a colectomy and 57 percent of cancers were prevented at an annual cost of $96,977.
Statin chemoprevention without surveillance prevented 90 percent of cancers, and 15 percent of patients required a colectomy. The average cost for lifetime care for this group was $108,051.
Even more promising, patients receiving statins and undergoing s
'"/>
16-May-2005