The collection of indirect and nonmedical direct costs (COIN) form: A new tool for collecting the invisible costs of androgen independent prostate carcinoma Journal Article

Authors: Sherman, E. J.; Pfister, D. G.; Ruchlin, H. S.; Rubin, D. M.; Radzyner, M. H.; Kelleher, G. H.; Slovin, S. F.; Kelly, W. K.; Scher, H. I.
Article Title: The collection of indirect and nonmedical direct costs (COIN) form: A new tool for collecting the invisible costs of androgen independent prostate carcinoma
Abstract: BACKGROUND. There are limited data available regarding the cost of care in patients with androgen independent prostate carcinoma (AIPC), and there are no data on the impact of direct nonmedical and indirect costs (DNM/IC). This lack of data, along with the feasibility of collecting DNM/IC, was examined in patients with AIPC who took part in a randomized trial using a newly developed questionnaire, the Collection of Indirect and Nonmedical Direct Costs (COIN) form. METHODS. Patients with AIPC were randomized to one of three treatment arms: 1) strontium only (strontium 4 Mci in Week 1 and Week 12) (STRONT); 2) vinblastine 4 mg/m2 per week for 3 weeks then 1 week off and estramustine, 10 mg/kg per day (CHEMO); or 3) a combination of treatments outlined in the arms for CHEMO and STRONT (CHEMO/STRONT). Direct medical costs were collected through the hospital billing system. DNM/IC data were obtained prospectively using the COIN form. Cost data were analyzed for a period of 6 months. RESULTS. Twenty-nine patients were randomized, after which the protocol was closed because of poor accrual. The median survival of the patients was 22.3 months. The mean and median total costs for the 20 of 29 patients with complete cost information were $12,647 and $11,257 over 6 months, respectively. DNM/IC represented 11% of the total cost (range, from > 1% to 42%); in 20% of participating individuals, these costs accounted for 35-42% of total costs. Failure to collect complete cost information was due to early death, administrative difficulties, and loss to follow-up. CONCLUSIONS. In this pilot project, the collection of these cost data using the COIN form was feasible and practical and was limited primarily by logistic, not form specific, issues. DNM/IC were found to be a significant proportion of total costs (up to 42%) in selected patients, and this information proved to be a useful addition to the cost analysis. Approximately 98 patients would be required to detect a 20% difference in total costs between arms in a properly powered, randomized trial. Considering the potentially significant impact on total costs, DNM/IC data should be included in future cost-analysis studies of patients with AIPC and other diseases. © 2001 American Cancer Society.
Keywords: clinical article; controlled study; aged; bone neoplasms; middle aged; androgen; clinical trial; constipation; diarrhea; antineoplastic agents; chemotherapy; follow up; adenocarcinoma; prostate specific antigen; controlled clinical trial; lung toxicity; pain; phase 2 clinical trial; nausea; randomized controlled trial; vinblastine; prostatic neoplasms; drug costs; health expenditures; questionnaire; malaise; survival time; pilot projects; health care costs; randomized trial; cost of illness; cost benefit analysis; prostate carcinoma; hospital costs; estramustine; cost analysis; hospital billing; strontium; humans; human; male; priority journal; article
Journal Title: Cancer
Volume: 91
Issue: 4
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2001-02-15
Start Page: 841
End Page: 853
Language: English
PUBMED: 11241254
PROVIDER: scopus
DOI: 10.1002/1097-0142(20010215)91:4<841::AID-CNCR1072>3.0.CO;2-B
Notes: Presented in part at the 34th Annual Meeting of the American Society of Clinical Oncology; 1998 May 16-19; Los Angeles, CA -- Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Susan Slovin
    186 Slovin
  2. William K Kelly
    110 Kelly
  3. Eric J Sherman
    152 Sherman
  4. David G Pfister
    251 Pfister
  5. Howard Scher
    835 Scher
  6. David M Rubin
    9 Rubin
  7. Geralyn A Higgins
    13 Higgins