SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer.
Br J Cancer
; 119(11): 1332-1338, 2018 11.
Article
in En
| MEDLINE
| ID: mdl-30420616
ABSTRACT
BACKGROUND:
The Short Course Oncology Therapy (SCOT) study is an international, multicentre, non-inferiority randomised controlled trial assessing the efficacy, toxicity, and cost-effectiveness of 3 months (3 M) versus the usually given 6 months (6 M) of adjuvant chemotherapy in colorectal cancer.METHODS:
In total, 6088 patients with fully resected high-risk stage II or stage III colorectal cancer were randomised and followed up for 3-8 years. The within-trial cost-effectiveness analysis from a UK health-care perspective is presented using the resource use data, quality of life (EQ-5D-3L), time on treatment (ToT), disease-free survival after treatment (DFS) and overall survival (OS) data. Quality-adjusted partitioned survival analysis and Kaplan-Meier Sample Average Estimator estimated QALYs and costs. Probabilistic sensitivity and subgroup analysis was undertaken.RESULTS:
The 3 M arm is less costly (-£4881; 95% CI -£6269; -£3492) and entails (non-significant) QALY gains (0.08; 95% CI -0.086; 0.230) due to a better significant quality of life. The net monetary benefit was significantly higher in 3 M under a wide range of monetary values of a QALY. The subgroup analysis found similar results for patients in the CAPOX regimen. However, for the FOLFOX regimen, 3 M had lower QALYs than 6 M (not statistically significant).CONCLUSIONS:
Overall, 3 M dominates 6 M with no significant detrimental impact on QALYs. The results provide the economic case that a 3 M treatment strategy should be considered a new standard of care.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Antineoplastic Combined Chemotherapy Protocols
/
Cost-Benefit Analysis
/
Oxaliplatin
Type of study:
Clinical_trials
/
Health_economic_evaluation
Aspects:
Patient_preference
Limits:
Humans
Language:
En
Journal:
Br J Cancer
Year:
2018
Document type:
Article
Affiliation country:
United kingdom