Introduction

Voice problems are common following radiotherapy for laryngeal cancer. Few studies exist covering the effect of voice rehabilitation, and no previous studies exist regarding the cost of said rehabilitation. This randomized controlled study aimed to analyze the cost-effectiveness of voice rehabilitation after radiotherapy for patients with laryngeal cancer.

Material and methods

A total of 66 patients with laryngeal cancer with follow-up data 12 months post-radiotherapy were included. Patients were randomized into receiving either voice rehabilitation (n = 32) or no voice rehabilitation (n = 34). The patient outcome was measured as quality-adjusted life years (QALYs). The index range between 0 and 1, where 0 equals death and 1 represents perfect health. The QALYs were assessed with the European Organization for Research and Treatment of Cancer questionnaire QLQ-C30 mapped to EuroQoL 5 Dimension values. The cost of rehabilitation and other healthcare visits was derived from hospital systems. The patients reported the total amount of sick leave days during the first 12 months following radiotherapy. The cost-effectiveness of the voice rehabilitation was compared with no rehabilitation intervention based on the incremental cost-effectiveness ratio.

Results

The cost per gained QALY with voice rehabilitation compared to no rehabilitation from a societal perspective was − 27,594 € (SEK − 250,852) which indicates that the voice rehabilitation is a cost-saving alternative compared to no rehabilitation due to lower costs and a slightly better health outcome. From a healthcare perspective, the voice rehabilitation indicates a cost 60,800 € (SEK 552,725) per gained QALY.

Conclusion

From a societal perspective, i.e., including the costs of production loss, voice rehabilitation compared to no voice rehabilitation following radiotherapy for laryngeal cancer seems to be cost-saving. When analyzing only the healthcare costs in relation to health outcomes, voice rehabilitation indicates an incremental cost of 60,800 € per gained QALY, which is just above the threshold of the maximum willingness to pay level.

中文翻译：

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喉癌患者发声康复的成本效益分析：一项随机对照研究。

 介绍

喉癌放疗后声音问题很常见。很少有研究涉及发声康复的效果，之前也没有关于所述康复费用的研究。这项随机对照研究旨在分析喉癌患者放疗后发声康复的成本效益。

 材料与方法

总共纳入了 66 名具有放疗后 12 个月随访数据的喉癌患者。患者被随机分为接受发声康复（ n = 32）或不接受发声康复（ n = 34）。患者结果以质量调整生命年（QALY）来衡量。该指数范围在0到1之间，其中0代表死亡，1代表完美健康。使用欧洲癌症研究与治疗组织问卷 QLQ-C30 映射到 EuroQoL 5 维度值来评估 QALY。康复和其他医疗保健就诊的费用来自医院系统。患者报告了放疗后前 12 个月内的病假总数。根据增量成本效益比，对嗓音康复与不进行康复干预的成本效益进行比较。

 结果

从社会角度来看，与不进行康复相比，通过嗓音康复获得的每次 QALY 成本为 − 27,594 欧元（SEK − 250,852），这表明与不进行康复相比，嗓音康复是一种节省成本的替代方案，因为成本较低且健康状况稍好结果。从医疗保健的角度来看，嗓音康复表明每获得 QALY 的费用为 60,800 欧元（552,725 瑞典克朗）。

 结论

从社会角度来看，即包括生产损失的成本，与喉癌放疗后不进行嗓音康复相比，嗓音康复似乎更节省成本。当仅分析与健康结果相关的医疗保健成本时，语音康复表明每获得 QALY 的增量成本为 60,800 欧元，略高于最大愿意支付水平的阈值。