Cost–utility analysis of a palliative care program in Colombia

Abstract

Background:The economic assessment of health care models in palliative care promotes their global development. The purpose of the study is to compare the cost–utility ratio of a palliative care program (named Contigo) with that of conventional care from the perspective of a health benefit plan administrator company, Sanitas, in Colombia. Methods: The incremental cost-effectiveness ratio was estimated using micro-costing in a retrospective, analytical cross-sectional study on the care of terminally ill patients enrolled in a palliative care program. A 6-month time horizon prior to death was used. The EQ-5D-3L questionnaire (EQ-5D-3L) and the McGill Quality of Life Questionnaire (MQOL) were used to measure the quality of life. Results: The study included 43 patients managed within the program and 16 patients who received conventional medical management. The program was found to be US dollars (USD) 1,789.41 less expensive than conventional practice (P = 0.01). When compared to the last 15 days, there is a higher perception of quality of life, which yielded 0.25 in the EQ-5D-3L (p < 0.01) and 1.55 in the MQOL (P < 0.01). The incremental cost–utility ratio per quality-adjusted life year was USD 290.11. Conclusion: Because the Contigo program reduces costs while improving quality of life, it is considered to be cost-effective and a model with value in health care. A greater availability of palliative care programs, such as Contigo, in Colombia can help reduce existing gaps in access to universal palliative care health coverage, resulting in more cost-effective care.