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dc.contributor.authorAndronis, Len_US
dc.contributor.authorGoranitis, Ien_US
dc.contributor.authorPirrie, Sen_US
dc.contributor.authorPope, Aen_US
dc.contributor.authorBarton, Den_US
dc.contributor.authorCollins, Sen_US
dc.contributor.authorDaunton, Aen_US
dc.contributor.authorMcLaren, Den_US
dc.contributor.authorO'Sullivan, JMen_US
dc.contributor.authorParker, Cen_US
dc.contributor.authorPorfiri, Een_US
dc.contributor.authorStaffurth, Jen_US
dc.contributor.authorStanley, Aen_US
dc.contributor.authorWylie, Jen_US
dc.contributor.authorBeesley, Sen_US
dc.contributor.authorBirtle, Aen_US
dc.contributor.authorBrown, JEen_US
dc.contributor.authorChakraborti, Pen_US
dc.contributor.authorHussain, SAen_US
dc.contributor.authorRussell, JMen_US
dc.contributor.authorBillingham, LJen_US
dc.contributor.authorJames, NDen_US
dc.date.accessioned2017-03-01T11:20:21Z
dc.date.issued2017-04en_US
dc.identifier.citationBJU international, 2017, 119 (4), pp. 522 - 529en_US
dc.identifier.issn1464-4096en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/415
dc.identifier.eissn1464-410Xen_US
dc.identifier.doi10.1111/bju.13549en_US
dc.description.abstract<h4>Objective</h4>To evaluate the cost-effectiveness of adding zoledronic acid or strontium-89 to standard docetaxel chemotherapy for patients with castrate-refractory prostate cancer (CRPC).<h4>Patients and methods</h4>Data on resource use and quality of life for 707 patients collected prospectively in the TRAPEZE 2 × 2 factorial randomised trial (ISRCTN 12808747) were used to assess the cost-effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium-89 versus no strontium-89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in the UK and included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality-adjusted life-years (QALYs) were calculated according to patients' responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results are expressed as incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves.<h4>Results</h4>The per-patient cost for ZA was £12 667, £251 higher than the equivalent cost in the no ZA group. Patients in the ZA group had on average 0.03 QALYs more than their counterparts in no ZA group. The ICER for this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08 QALYs compared to no Sr89. The ICER for Sr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.<h4>Conclusions</h4>The addition of bone-targeting treatments to standard chemotherapy led to a small improvement in QALYs for a modest increase in cost (or cost-savings). ZA and Sr89 resulted in ICERs below conventional willingness-to-pay per QALY thresholds, suggesting that their addition to chemotherapy may represent a cost-effective use of resources.en_US
dc.formatPrint-Electronicen_US
dc.format.extent522 - 529en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectHumansen_US
dc.subjectBone Neoplasmsen_US
dc.subjectStrontiumen_US
dc.subjectDiphosphonatesen_US
dc.subjectImidazolesen_US
dc.subjectAntineoplastic Combined Chemotherapy Protocolsen_US
dc.subjectRadiopharmaceuticalsen_US
dc.subjectDisease-Free Survivalen_US
dc.subjectProspective Studiesen_US
dc.subjectQuality of Lifeen_US
dc.subjectCost-Benefit Analysisen_US
dc.subjectMaleen_US
dc.subjectBone Density Conservation Agentsen_US
dc.subjectAntibodies, Monoclonal, Humanizeden_US
dc.subjectProstatic Neoplasms, Castration-Resistanten_US
dc.subjectUnited Kingdomen_US
dc.subjectZoledronic Aciden_US
dc.titleCost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747).en_US
dc.typeOther
rioxxterms.versionofrecord10.1111/bju.13549en_US
rioxxterms.licenseref.startdate2017-04en_US
rioxxterms.typeotheren_US
dc.relation.isPartOfBJU internationalen_US
pubs.issue4en_US
pubs.notesNo embargoen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Prostate and Bladder Cancer Research
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublisheden_US
pubs.volume119en_US
pubs.embargo.termsNo embargoen_US
icr.researchteamProstate and Bladder Cancer Researchen_US
dc.contributor.icrauthorParker, Chrisen_US
dc.contributor.icrauthorJames, Nicholasen_US


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