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SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant oxaliplatin combination chemotherapy for colorectal cancer.
Robles-Zurita, J Boyd, KA Briggs, AH Iveson, T Kerr, RS Saunders, Mark P Cassidy, J Hollander NH Tabernero, J Segelov, E
Robles-Zurita, J
Boyd, KA
Briggs, AH
Iveson, T
Kerr, RS
Saunders, Mark P
Cassidy, J
Hollander NH
Tabernero, J
Segelov, E
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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
Authors
Robles-Zurita, J
Boyd, KA
Briggs, AH
Iveson, T
Kerr, RS
Saunders, Mark P
Cassidy, J
Hollander NH
Tabernero, J
Segelov, E
Glimelius, B
Harkin, A
Allan, K
McQueen, J
Pearson, S
Waterston, A
Medley, L
Wilson, C
Ellis, R
Essapen, S
Dhadda, AS
Hughes, R
Falk, S
Raouf, S
Rees, C
Olesen, RK
Propper, D
Bridgewater, J
Azzabi, A
Farrugia, D
Webb, A
Cunningham, D
Hickish, T
Weaver, A
Gollins, S
Wasan, HS
Paul J
Boyd, KA
Briggs, AH
Iveson, T
Kerr, RS
Saunders, Mark P
Cassidy, J
Hollander NH
Tabernero, J
Segelov, E
Glimelius, B
Harkin, A
Allan, K
McQueen, J
Pearson, S
Waterston, A
Medley, L
Wilson, C
Ellis, R
Essapen, S
Dhadda, AS
Hughes, R
Falk, S
Raouf, S
Rees, C
Olesen, RK
Propper, D
Bridgewater, J
Azzabi, A
Farrugia, D
Webb, A
Cunningham, D
Hickish, T
Weaver, A
Gollins, S
Wasan, HS
Paul J
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Date
2018
Publisher
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Article
Citation
Robles-Zurita J, Boyd KA, Briggs AH, Iveson T, Kerr RS, Saunders MP, et al. 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. 2018 Nov;119(11):1332-8.