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The survival benefit and cost-effectiveness of a pancreatic cancer early detection strategy for a targeted population of new-onset diabetes patients

Johannssen, T.F. (2022) The survival benefit and cost-effectiveness of a pancreatic cancer early detection strategy for a targeted population of new-onset diabetes patients.

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Abstract:A growing body of evidence suggests that high-risk individuals among a new-onset diabetes (NOD) population should be tested for PC. This thesis evaluates a targeted early detection (TED) strategy where a population of NOD patients aged ≥50 years, enriched by a clinical prediction model in combination with a biomarker panel of serum IL-1Ra and adiponectin levels, undergoes one-time diagnostic tests for PC. The research questions of this thesis are whether the TED strategy is cost-effective compared to the current standard of care (SoC) of no early testing and if it results in improved clinical benefits for PC patients in the NOD population. An integrated decision tree and Markov cohort model was built based on U.S. clinical guidelines. Costs and clinical benefits, measured in terms of life-years (LYs) and quality-adjusted life years (QALYs) gained, are tracked over a lifetime horizon. Cost-effectiveness is measured in terms of the incremental cost-effectiveness ratio (ICER). While the TED strategy is cost-effective compared to the current SoC at a $100,000 WTP threshold, the ICER is not a suitable measure given a low clinical benefit. While the TED strategy yielded clinically relevant benefits among only PC patients, the impact on long-term survival (≥ 5 years) is small.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 83 economics
Programme:Industrial Engineering and Management MSc (60029)
Link to this item:https://purl.utwente.nl/essays/92991
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