SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer.
Loading...
Embargo End Date
ICR Authors
Authors
Robles-Zurita, J
Boyd, KA
Briggs, AH
Iveson, T
Kerr, RS
Saunders, MP
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, MP
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
Document Type
Journal Article
Date
2018-11-27
Date Accepted
2018-10-09
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.
Citation
British journal of cancer, 2018, 119 (11), pp. 1332 - 1338
Source Title
Publisher
SPRINGERNATURE
ISSN
0007-0920
eISSN
1532-1827
Collections
Research Team
Medicine (RMH Smith Cunningham)