Economic Evaluation in Adolescent and Young Adult Cancer: Methodological Considerations and the State of the Science

Despite the considerable prevalence and incidence of cancer cases among adolescents and young adults (AYAs) and a growing attention to the economics of cancer care, few studies have addressed the economic impact of cancer in AYAs. In this chapter we discuss four important aspects of cancer care economics as they pertain to the AYA population. We begin with an overview of the unique factors that contribute to cost and disease burden in cancer. This is followed by a discussion of health-related quality of life (HRQL) considerations in relation to economic analysis. We then describe types of economic analyses that provide estimates of costs and benefits, with benefits defined as improved survival and/or improved quality-adjusted survival. In the final section, we discuss how HRQL can be used to predict future clinical outcomes and healthcare utilization and, thus, expenditures. In the absence of a rich evidence base, we instead provide a guide to the reader as to how to create the data to support future science in this area.