Author(s)
Catella L1, Cancalon C1, Lafourcade A2, de Rycke Y2, Guillo S2, Tubach F3, Dalichampt M4, Jacquard A5, Largeron N6, Dahlab A6, Uhart M6, Bresse X6, Bergeron C7, Borne H8, Bénard S1
1st[è]ve consultants, Oullins, France, 2NSERM UMR 1123 ECEVE, Hôpital Bichat Claude Bernard, Paris, France, 3APHP, Département d'Epidémiologie et Recherche Clinique CIC-EC 1425, Centre de Pharmacoépidémiologie (Cephepi); University Paris Diderot, Sorbonne Paris Cité, Unité Mixte de Recherche (UMR) 1123: Epidémiologie clinique, évaluation économique et population, Paris, France, 4Biostatistician, Nantes, France, 5Sanofi Pasteur MSD France, Lyon, France, 6Sanofi Pasteur MSD, Lyon, France, 7Laboratoire Cerba, Saint-Ouen-l'Aumône, France, 8Gynecologist, Paris, France
OBJECTIVES: HPV infection can lead to cervical intraepithelial neoplasia (CIN), which can progress in cervical cancer (CC) if untreated. Screening prevents CC by detecting and removing CIN lesions detected as abnormal pap smears. We conducted a study to update figures related to the diagnosis and treatment pathways related to these lesions based on representative claims databases in France. METHODS: A retrospective, cross-sectional, observational study was performed using the “Echantillon généraliste des bénéficiaires” (EGB) and the French hospital discharge database (PMSI) of year 2013. EGB, which includes data related to primary and secondary care in a sample of French people, allowed to collect data on screening and procedures used for the management of abnormal pap smears (no ICD-10 codes are available). PMSI, which includes exhaustive secondary care data, allowed to extract patients with hospitalizations for CIN (ICD-10 codes: N87* and D06*). RESULTS: Analysis of the EGB shows important healthcare consumptions in primary care with 5,097,960 pap smears, 369,967 colposcopies, 131,172 HPV tests and 15,162 laser excisions. Analysis of the PMSI database indicates that 34,067 women were hospitalized with a diagnosed CIN, (7,388 CIN1, 25 368 CIN2+ and 1,311 unspecified CIN. Overall 28,196 conizations were registered, other major treatments in hospital were laser excisions and removal surgeries. Mean costs per stay were 1,032.11±811.95€ for CIN1, 1,177.27±1,046.87€ for CIN 2 and 1,544.04±1,397.78€ for unspecified CIN. CONCLUSIONS: This study is the first to combine robust data coming from two national databases in France. Although all procedures are not recorded in the EGB, it highlights the burden related to screening and diagnosis of abnormal pap smears, as well as the burden of CIN’s management in hospitals even though it represents only a part of the management of all CIN. The evaluation of costs concerns patients that are treated, since most of CIN1 are only monitored.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHS35
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology