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. A. et al. (2018) SCOT: A comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer. British Journal of Cancer, (doi:10.1038/s41416-018-0319-z) (Early Online Publication)

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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.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Paul, Mr James and Allan, Ms Karen and Robles-Zurita, Dr Jose Antonio and Briggs, Professor Andrew and Cassidy, Professor James and Mcqueen, Mr John and Boyd, Dr Kathleen
Authors: Robles-Zurita, J. A., Boyd, K. A., Briggs, A. H., Iveson, T., Kerr, R. S., Saunders, M. P., Cassidy, J., Hollander, N. H., Tabernero, J., Seglov, E., Glimelius, B., Harkin, A., Allan, K., Mcqueen, J., Pearson, S., Waterston, A., Medley, L., Wilson, C., Ellis, R., Essapen, S., Dhadda, A. S., Hughes, R., Falk, S., Raouf, S., Rees, C., Olesen, R. K., Propper, D., Bridgewater, J., Azzabi, A., Farrugia, D., Webb, A., Cunningham, D., Hickish, T., Weaver, A., Gollins, S., Wasan, H. S., and Paul, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:British Journal of Cancer
Publisher:Springer Nature
ISSN:0007-0920
ISSN (Online):1532-1827
Published Online:13 November 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in British Journal of Cancer
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
430581SCOT - short course oncology therapy - a study of adjuvant chemotherapy in colorectal cancer by the CACTUS & QUASAR 3 groupsJames PaulMedical Research Council (MRC)G0601705/80721RI CANCER SCIENCES