PATIENT AND HEALTH SYSTEM COST SAVINGS IN A MULTIDISCIPLINARY LUNG CANCER CLINIC

      SESSION TITLE: Education, Research, and Quality Improvement Posters
      SESSION TYPE: Original Investigation Posters
      PRESENTED ON: October 18-21, 2020
      PURPOSE: Lung cancer (LC) care is resource and cost intensive. A previous evaluation of a Multidisciplinary LC Clinic (MDC) at Kingston Health Sciences Centre in Kingston, Ontario, Canada, demonstrated that patients with a new LC diagnosis seen in a multidisciplinary model, with concurrent Pulmonology and Oncology consultations, experienced faster oncology assessment, shorter times to treatment, and a reduced number of clinic visits from diagnosis to treatment. In this economic evaluation, we report cost savings from the implementation of the MDC.
      METHODS: Standard methods of cost analysis were used. Resource use and costs were evaluated retrospectively for MDC implementation. Analyses were conducted from the societal perspective, with costs presented in 2019 Canadian dollars (CDN). We estimated total cost savings due to the reduction in clinic visits resulting from MDC implementation based on the analysis of all patients seen in the MDC from Feb 2017–Dec 2018. Productivity loss, travel-related costs, and administrative costs associated with booking clinic visits were evaluated. Multi-way sensitivity analyses were conducted to examine the impact of uncertainty on study results.
      RESULTS: In a sample of 350 patients seen in MDC, 271 (77%) were >65 years of age. MDC patients required 1.06 fewer oncology visits from LC diagnosis to first treatment, resulting in 371 fewer oncology visits over the study period. Travel costs were estimated using the Government of Canada automobile allowance rate ($0.58/km) and the mean round trip distance between patients’ homes and KHSC (101.96 km/visit), amounting to $21,940.94 in savings. Savings related to parking expenses ($3/hr) resulted in total cost savings of $2,226.00. The total out-of-pocket savings for n=350 patients were $24,166.94, or ˜$70/patient. Savings related to patient and caregiver productivity loss were calculated using the average wage for Canadians over the age of 25 ($29.55/hr), and all patients <65 years of age (23%) were included in the analysis. Additional parameters such as travel time (61.2 mins), clinic visit time (75.6 mins), parking/time spent locating the clinic (15 mins) and an average of 1.25 caregivers/patient helped inform our calculations. Patient and caregiver productivity-loss cost savings totalled $6,379.40 and $17,335.32, respectively. Clinic administrative level savings amounted to $508.27 (3 mins/booking; average wage $27.33/hr). The cost analysis was moderately sensitive to changes in productivity loss.
      CONCLUSIONS: A lung cancer MDC led to patient and health system economic benefits, with a total cost reduction of $48,389.93 over approximately 2 years (range: $37,173.37 - $122,896.42).
      CLINICAL IMPLICATIONS: This study identifies patient and health system economic benefits that add further evidence in support of multidisciplinary lung cancer care.
      DISCLOSURES: No relevant relationships by Genevieve Digby, source=Web Response
      No relevant relationships by Ana Johnson, source=Web Response
      No relevant relationships by Andriy Katyukha, source=Web Response
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      Advisory Committee Member relationship with Merck Please note: $1001 - $5000 Added 05/26/2020 by Andrew Robinson, source=Web Response, value=Honoraria
      Advisory Committee Member relationship with Astra Zeneca Please note: $1001 - $5000 Added 05/26/2020 by Andrew Robinson, source=Web Response, value=Consulting fee
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