Cancer

Staff of the Economics of cancer research stream include:

Stream Lead:
Associate Professor Nikki McCaffrey

Research Fellows:
Dr Ann Livingstone
Dr Clement Wong
Ms Jessica Bucholc

PhD Students:
Bedasa Taye Merga

Emeritus Professor:
Emeritus Professor Rob Carter

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.

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).

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, such as social return on investment analysis and discrete choice experiments, 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 conducted 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 on a new, multi attribute utility instrument to measure quality of life in the palliative and end-of-life 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.

Other notable cancer-related research conducted within DHE includes workforce planning (Associate Professor Lan Gao), examining variations in utilisation of colorectal cancer services (Dr Anita Lal) and modelling the impact of restricting junk food advertising (Associate Professor Jaithri Ananthapavan)

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

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.

Crosland P, Scollo M, White S, McCaffrey (2023). Cost-effectiveness and productivity impacts of call-back telephone counselling for smoking cessation. Public Health Research & Practice; 33(4):33232306.

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.

Inequities in cancer:
McCaffrey N, Cheah SL, Luckett T, Phillips JL, Agar M, Davidson PM, Boyle F, Shaw T, Currow DC, Lovell M (2023). Treatment patterns and out-of-hospital healthcare resource utilisation by patients with advanced cancer living with pain: An analysis from the Stop Cancer PAIN trial. PLoS One;18(2):e0282465.

Methodological research:
McCaffrey N, Ratcliffe J, Currow D, Engel L, Hutchinson C (2024). ‘What aspects of quality of life are important from palliative care patients’ perspectives? A framework analysis to inform preference-based measures for palliative and end-of-life settings’, The Patient;17(1)39-52.

Livingstone A, Howard K, Menzies AM, Long GV, Stockler MR, Morton RL (2023). Preferences for Adjuvant Immunotherapy in Adults with Resected Stage III Melanoma-A Discrete Choice Experiment. Patient;16(5):497-513.

Bucholc J, McCaffrey N, Ugalde A, Muldowney A, Rand S, Hoefman R, Mihalopoulos C, Engel L (2023). ‘How well do the Adult Social Care Outcomes Toolkit for Carers, Carer Experience Scale and Care-related Quality of Life capture aspects of quality of life important to informal carers in Australia?’ Quality of Life Research;32(11):3109-3121.

Burden of disease studies/reviews:
Livingstone A, Murphy A, Bucholc J, Engel L, McCaffrey N (2024). Protocol for a Systematic Review of qualitative research exploring important service characteristics of telephone cancer information and support services for callers’, BMJ Open;14(1):e078399.

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.