Economic Evaluations of Breast Cancer Care in Low- and Middle-Income Countries: A Scoping Review

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Economic Evaluations of Breast Cancer Care in Low- and Middle-Income Countries: A Scoping Review


JournalThe Oncologist
Article typeJournal research article – Clinical research
Publication date – May – 2021
Authors – Parsa Erfani, Kayleigh Bhangdia, Catherine Stauber, Jean Claude Mugunga, Lydia E. Pace, Temidayo Fadelu
KeywordsBreast Cancer, Costs, Developing Countries, health economics, Review
Open access – Yes
SpecialityGeneral surgery, Surgical oncology
World region Global

Language – English
Submitted to the One Surgery Index on June 4, 2021 at 7:38 am
Abstract:

Background
Understanding the cost of delivering breast cancer (BC) care in low- and middle-income countries (LMICs) is critical to guide effective care delivery strategies. This scoping review summarizes the scope of literature on the costs of BC care in LMICs and characterizes the methodological approaches of these economic evaluations.

Materials and Methods
A systematic literature search was performed in five databases and gray literature up to March 2020. Studies were screened to identify original articles that included a cost outcome for BC diagnosis or treatment in an LMIC. Two independent reviewers assessed articles for eligibility. Data related to study characteristics and methodology were extracted. Study quality was assessed using the Drummond et al. checklist.

Results
Ninety-one articles across 38 countries were included. The majority (73%) of studies were published between 2013 and 2020. Low-income countries (2%) and countries in Sub-Saharan Africa (9%) were grossly underrepresented. The majority of studies (60%) used a health care system perspective. Time horizon was not reported in 30 studies (33%). Of the 33 studies that estimated the cost of multiple steps in the BC care pathway, the majority (73%) were of high quality, but studies varied in their inclusion of nonmedical direct and indirect costs.

Conclusion
There has been substantial growth in the number of BC economic evaluations in LMICs in the past decade, but there remain limited data from low-income countries, especially those in Sub-Saharan Africa. BC economic evaluations should be prioritized in these countries. Use of existing frameworks for economic evaluations may help achieve comparable, transparent costing analyses.

OSI Number – 21122

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