Cancer

Staff of the Economics of cancer research stream include:

Level D:
Dr Nikki McCaffrey

Level C:
Dr Anita Lal

Level B:
Ms Jessica Bucholc
Dr Ann Livingstone

PhD Students:
Bedasa Taye Merga

Emeritus Professor:
Emeritus Professor Rob Carter

We specialise in partnering with our collaborators to ensure that all trials we’re involved with have robust, practical and state of the art economic evaluation techniques embedded within the trial protocols. Our evaluations range from preventive to treatment interventions across a range of cancers, spanning the stages of the cancer care continuum (prevention, early detection, diagnosis, treatment, survivorship, end of life) and across multiple settings (such as primary care, acute-care hospitals, long-term care facilities and home-based care).

Our team specialises in using economic modelling techniques to evaluate the cost-effectiveness of single or multiple interventions within the one study context. Modelled economic evaluations can overcome the limitation of trial-based economic evaluations (such as a short time horizon) or can be undertaken when a trial-based economic evaluation is not feasible. Depending on the context of the research questions and purpose, we adopt different methodological frameworks like more traditional cost-utility analyses where outcomes are expressed in generic units such as quality-adjusted life years (QALYs) to return on investment studies. We also specialise in large-scale priority setting studies where multiple interventions are compared within the same study context using the well-recognised Assessing Cost-Effectiveness (ACE) approach.

Inequities exist across the cancer spectrum from prevention through to end-of-life care due to socioeconomic position, area of residence and cultural and linguistic diversity. Our research uses linked datasets to quantify inequities in the distribution of health and healthcare resources and interventions are analysed for their cost-effectiveness and equity impacts on disadvantaged groups. Our collaborators at the University of South Australia BreastScreen SA bring extensive experience in cancer epidemiology and biostatistics.

We undertake research dedicated to ensuring that the methods and techniques we use are appropriate and fit for purpose in the cancer context. This is essential in ensuring that cancer care is not disadvantaged because of limitations in the methods used to assess outcomes in economic evaluations.  For example, we recently completed a study where the main instruments used by health economists to measure carer-related quality of life were evaluated in people providing informal care in Australia to ensure they were fit for purpose. We are also completing work investigating whether these carer-related instruments are sufficient in the palliative and end-of-life care setting.

We evaluate the costs and disease burden, for example quality of life losses from cancer, as well as for risk factors, such as smoking. We use nationally representative databases to undertake this research (such as community-based surveys) as well as smaller, more bespoke datasets which include information on people who may not feature in larger datasets.

Brief examples of our work spanning these areas of research include:

Trial-based economic evaluations:
McCaffrey N, Flint T, Kaambwa B, Fazekas B, Rowett D, Currow DC, Hardy J, Agar M, Quinn S, Eckermann S (2019). Economic evaluation of the randomised, double-blind, placebo-controlled study of subcutaneous ketamine in the management of chronic cancer pain. Palliative Medicine;33(1):74-81. doi: 10.1177/0269216318801754.

Modelled/priority setting studies:
McCaffrey N, Scollo M, Dean E, White S (2021). What is the likely impact on surgical site infections in Australian hospitals if smoking rates are reduced? A modelled analysis, PLoS ONE; 16(8): e0256424, doi: 10.1371/journal.pone.0256424.

Lal A, Mihalopoulos C, Wallace A, Vos T (2014). The cost–effectiveness of call-back counselling for smoking cessation. Tobacco Control;23(5):437-42.

Inequities in cancer:
Lal A, McCaffrey N, Gold L, Roder D, Buckley E. (2022) Variations in utilisation of colorectal cancer services in South Australia indicated by MBS/PBS benefits: A benefit incidence analysis. ANZJPH  Apr;46(2):237-242  doi: 10.1111/1753-6405.13197

Methodological research:
McCaffrey N, Bucholc J, Rand S, Hoefman R, Ugalde A, Muldowney A, Mihalopoulos C, Engel L (2020). Head- to-head comparison of the psychometric properties of three carer-related preference-based instruments, Value in Health; 23(11):1477-1488, doi: 10.1016/j.jval.2020.07.005.

Burden of disease studies/reviews:
McCaffrey N, Higgins J, Greenhalgh E, White SL, Graves N, Myles PS, Cunningham JE, Dean E, Doncovio S, Briggs L, Lal A (2022).‘A systematic review of economic evaluations of preoperative smoking cessation for preventing surgical complications, International Journal of Surgery, 104:106742, doi: 10.1016/j.ijsu.2022.106742. Epub 2022 Jun 25.

Defining & optimising the economic and social return on investment of telephone cancer information and support services (CISS) for all Australians’

This novel and rigorous program of research will determine, for the first time, the economic and social return on investment of an oncology nurse-led CISS in Victoria.

Find out more.