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Treatment Patterns, Health Care Utilization, and Costs of Ovarian Cancer in Central and Eastern Europe Using a Delphi Panel Based on a Retrospective Chart Review

Kim, Kun MSc*; Hernlund, Emma PhD*; Hernadi, Zoltán MD; Révész, János MD; Pete, Imre PhD, MD§; Szánthó, András PhD, MD; Bodnar, Lubomir MD; Madry, Rodoslaw MD#; Timorek–Lemieszczuk, Agnieszka PhD, MD**; Bozanovic, Tatjana MD††; Vasovic, Suzana MD‡‡; Tomasevic, Zorica PhD, MD‡‡; Zivaljevic, Milica MD§§; Pazin, Vladimir MD∥∥; Minárik, Tomáš PhD, MD¶¶; Garanová, Hana MD##; Heľpianska, Lýdia MD***; Justo, Nahila MBA, MSc*

International Journal of Gynecological Cancer: June 2013 - Volume 23 - Issue 5 - p 823–832
doi: 10.1097/IGC.0b013e318291e8ca
Ovarian Cancer

Objective Despite the considerable disease burden of ovarian cancer, there were no cost studies in Central and Eastern Europe. This study aimed to describe treatment patterns, health care utilization, and costs associated with treating ovarian cancer in Hungary, Poland, Serbia, and Slovakia.

Method Overall clinical practice for management of epithelial ovarian cancer was investigated through a 3-round Delphi panel. Experts completed a survey based on the chart review (n = 1542). The survey was developed based on clinical guidelines and the International Federation of Gynecology and Obstetrics Annual Report. Means, ranges, and outlier values were discussed with the experts during a telephone interview. Finally, consensus estimates were obtained in face-to-face workshops. Based on these results, overall cost of ovarian cancer was estimated using a Markov model.

Results The patients included in the chart review were followed up from presurgical diagnosis and in each phase of treatment, that is, surgical staging and primary surgery, chemotherapy and chemotherapy monitoring, follow-up, and palliative care. The 5-year overall cost per patient was €14,100 to €16,300 in Hungary, €14,600 to €15,800 in Poland, €7600 to €8100 in Serbia, and €12,400 to €14,500 in Slovakia. The main components were chemotherapy-associated costs (68%–74% of the total cost), followed by cost of primary treatment with surgery (15%–21%) and palliative care (3%–10%).

Conclusions Patients with ovarian cancer consume considerable health care resources and incur substantial costs in Central and Eastern Europe. These findings may prove useful for clinicians and decision makers in understanding the economic implications of managing ovarian cancer in Central and Eastern Europe and the need for innovative therapies.

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*OptumInsight, Stockholm, Sweden; †Department of Gynecologic Oncology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary; ‡Department of Gynecology, County Hospital of BAZ, Miskolc, Hungary; §National Institute of Oncology, Budapest, Hungary, and ∥1st Department of Gynecology, Semmelweis University Faculty of Medicine, Budapest, Hungary; ¶Department of Oncology, Military Institute of Medicine, Warsaw, Poland; #Poznań University ofMedical Sciences, Poznań, Poland, and **Warsaw Medical University, Warsaw, Poland; ††Medical Faculty, University of Belgrade, Belgrade, Serbia; ‡‡Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; §§Institute for Oncology of Vojvodina, Sremska Kamenica, Serbia, and ∥∥Gynecology and Obstetrics “Narodni Front,” Belgrade, Serbia; and ¶¶Národný onkologicky ústav, Bratislava, Serbia, and ##Východoslovenský onkologický ústav, Košice, Slovak Republic and ***Onkologický ústav sv. Alžbety, Bratislava, Slovak Republic.

Address correspondence and reprint requests to Kun Kim, MSc, Klarabergsviadukten 90, Hus D, 11164 Stockholm, Sweden. E-mail:

This study was financially supported by Roche (F. Hoffmann-La Roche Ltd).

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The authors declare no conflicts of interest.

Received November 1, 2012

Accepted March 13, 2013

Copyright © 2013 by IGCS and ESGO