Disputation: Gudrun Maria Waaler Bjørnelv

M.Phil. Gudrun Maria Waaler Bjørnelv at Institute of Health and Society will be defending the thesis Health Care Utilization, Costs and Benefits of Treatments in Metastatic Colorectal Cancer for the degree of PhD.

Foto: Øystein Horgmo

Trial Lecture - time and place

See Trial Lecture.

Adjudication committee

  • 1st opponent: Senior Research Fellow Nikki McCaffrey, Deakin University
  • 2nd opponent: Director of Assessment Pekka Rissanen, National Institute for Health and Welfare, Helsinki
  • Committee Chair: Associate Professor Thomas de Lange, University of Oslo

Chair of the Defence

Professor Kari Nyheim Solbrække

Principal Supervisor

Associate Professor Eline Aas


Economic evaluations consider both costs and benefits of new interventions and are performed to inform decision makers regarding priorities in the health care sector.

Colorectal cancer is the third-most common cancer, and the third-most common cause of cancer-related deaths. It is also the most resource demanding cancer in Norway. Colorectal cancers frequently metastasize to the liver, but the economic evidence for curative treatments for colorectal liver metastases, and colorectal cancer patients’ end-of life, remains limited. As a response, Gudrun Waaler Bjørnelv and her co-authors performed three economic evaluations targeting these patients in her dissertation titled Health Care Utilization, Costs, and Benefits of Treatments in Metastatic Colorectal Cancer.

In the first analysis (paper I), performed within a randomized controlled trial, they found that laparoscopic liver surgery, compared to open surgery, led to higher benefits to equal costs for patients with resectable liver metastases. Paper II, which was performed within a mathematic simulation model, showed that liver transplantation compared to chemotherapy-alone for patients with non-resectable liver-only metastases led to substantial increased costs, but also to high health benefits (3-4 life years gained). Lastly, paper III, which was performed by linking six national registers, showed that colorectal cancer decedents on average spent two of their last six months of life in institutions. Married patients (i.e., with access to informal care) stayed 30 more days at home than the never-married but used more primary and secondary health care services.

The findings support the implementation of laparoscopic surgery and defends the implementation of liver transplantation (in selected patients). The results also show the importance of simultaneously considering care in all levels of the health care sector, in addition to informal care, when researching and planning care delivery for patients at their end-of-life.

Additional information

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Published Jan. 10, 2019 4:08 PM - Last modified Jan. 11, 2019 9:57 AM