SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant oxaliplatin combination chemotherapy for colorectal cancer.
Saunders, Mark P
AffiliationInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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AbstractBACKGROUND: 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
CitationRobles-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.
JournalThe British Journal of Cancer
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