Economic and Environmental Impact of Decentralized Cancer Care (DCC) in Oncology: An Innovative Experience in the French Alps
Author(s)
Lionel Perrier, PhD1, Pierre Avenas, Ing1, Magali Morelle, MSc1, Aurore Florentin, MD2, Fabienne GRAILLES, MD2, Emmanuelle Jacquet, MD2, Valérie LEGRAND, MD3, Elisabeth Milliex, MD4, Thierry Durand, Ing1, Guillaume Moriceau, MD5, Jocelyne Provençal, MD5, Yohan Fayet, PhD6.
1Cancer Centre Leon Berard, Lyon, France, 2Centre hospitalier intercommunal Albertville-Moûtiers, Albertville, France, 3Centre Hospitalier Bugey Sud, Belley, France, 4Centre Hospitalier Vallée de la Maurienne, Saint Jean de Maurienne, France, 5Centre Hospitalier Métropole Savoie, Chambéry, France, 6Université Clermont Auvergne, Clermont-Ferrand, France.
1Cancer Centre Leon Berard, Lyon, France, 2Centre hospitalier intercommunal Albertville-Moûtiers, Albertville, France, 3Centre Hospitalier Bugey Sud, Belley, France, 4Centre Hospitalier Vallée de la Maurienne, Saint Jean de Maurienne, France, 5Centre Hospitalier Métropole Savoie, Chambéry, France, 6Université Clermont Auvergne, Clermont-Ferrand, France.
Presentation Documents
OBJECTIVES: The concentration of cancer care in regional cities is creating new constraints for patients from peripheric aeras. Innovative organizations that can help overcome these potential vulnerabilities need to be evaluated. The aim of this research study was to measure the economic and environmental impact of decentralized cancer care (DCC) in Savoy, France.
METHODS: A decision tree was constructed using Treeplan SensIt® over a time horizon of 12 months. Disease management and probabilities were based on a cohort of patients who had a DCC at the Albertville Moutiers, Bugey-sud or the Vallée de la Maurienne hospital. Resource use items were provided by local hospital discharge databases. This study was conducted retrospectively (CNIL MR004 R201-004-471, 30/07/2024). Total costs per patient included hospitalizations, decentralized medical specialists’ consultations, transportations based on the distance (in km) between the municipality of residence and the place where the DCC was delivered vs. the Centre Hospitalier Métropole Savoie. Medical specialists travel costs were included. The costs were assessed for each pathway and expressed in Euros 2023 and calculated for both with vs. without DCC. CO2 emissions were assessed using values provided by the European Environment Agency. Sensitivity analyses were performed. All statistical analyses were performed using R® software.
RESULTS: A total of 252 patients underwent DCC between 1st January and 30 June 2023. 6 patients were excluded due to consent withdrawal. Mean total costs (SD) per patient were €8,312 (19,238) when disease management was based on DCC and €9,515 (20,204) when not (p<0.001). On the whole sample, DCC allowed to save 282,861 km, resulting in a cost saving of €290,279 and a reduction of 34.6 tons of CO2.
CONCLUSIONS: In addition to benefits for patients in terms of geographical and family closeness, our model demonstrated that DCC are likely to provide cost-savings for the French NHI and help fight climate change.
METHODS: A decision tree was constructed using Treeplan SensIt® over a time horizon of 12 months. Disease management and probabilities were based on a cohort of patients who had a DCC at the Albertville Moutiers, Bugey-sud or the Vallée de la Maurienne hospital. Resource use items were provided by local hospital discharge databases. This study was conducted retrospectively (CNIL MR004 R201-004-471, 30/07/2024). Total costs per patient included hospitalizations, decentralized medical specialists’ consultations, transportations based on the distance (in km) between the municipality of residence and the place where the DCC was delivered vs. the Centre Hospitalier Métropole Savoie. Medical specialists travel costs were included. The costs were assessed for each pathway and expressed in Euros 2023 and calculated for both with vs. without DCC. CO2 emissions were assessed using values provided by the European Environment Agency. Sensitivity analyses were performed. All statistical analyses were performed using R® software.
RESULTS: A total of 252 patients underwent DCC between 1st January and 30 June 2023. 6 patients were excluded due to consent withdrawal. Mean total costs (SD) per patient were €8,312 (19,238) when disease management was based on DCC and €9,515 (20,204) when not (p<0.001). On the whole sample, DCC allowed to save 282,861 km, resulting in a cost saving of €290,279 and a reduction of 34.6 tons of CO2.
CONCLUSIONS: In addition to benefits for patients in terms of geographical and family closeness, our model demonstrated that DCC are likely to provide cost-savings for the French NHI and help fight climate change.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE379
Topic
Economic Evaluation
Disease
SDC: Oncology