Cost-effectiveness of 5 fraction and partial breast radiotherapy for early breast cancer in the UK: model-based multi-trial analysis.
Breast Cancer Res Treat
; 197(2): 405-416, 2023 Jan.
Article
en En
| MEDLINE
| ID: mdl-36396774
ABSTRACT
PURPOSE:
We estimated the cost-effectiveness of 4 radiotherapy modalities to treat early breast cancer in the UK. In a subgroup of patients eligible for all modalities, we compared whole-breast (WB) and partial breast (PB) radiotherapy delivered in either 15 (WB15F, PB15F) or 5 fractions (WB5F, PB5F). In a subgroup ineligible for PB radiotherapy, we compared WB15F to WB5F.METHODS:
We developed a Markov cohort model to simulate lifetime healthcare costs and quality-adjusted life years (QALYs) for each modality. This was informed by the clinical analysis of two non-inferiority trials (FAST Forward and IMPORT LOW) and supplemented with external literature. The primary analysis assumed that radiotherapy modality influences health only through its impact on locoregional recurrence and radiotherapy-related adverse events.RESULTS:
In the primary analysis, PB5F had the least cost and greatest expected QALYs. WB5F had the least cost and the greatest expected QALYs in those only eligible for WB radiotherapy. Applying a cost-effectiveness threshold of £15,000/QALY, there was a 62% chance that PB5F was the cost-effective alternative in the PB eligible group, and there was a 100% chance that WB5F was cost-effective in the subgroup ineligible for PB radiotherapy.CONCLUSIONS:
Hypofractionation to 5 fractions and partial breast radiotherapy modalities offer potentially important benefits to the UK health system.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Neoplasias de la Mama
Tipo de estudio:
Health_economic_evaluation
Aspecto:
Patient_preference
Límite:
Female
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Breast Cancer Res Treat
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido