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, 119(11), pp. 1332-1338. (doi: 10.1038/s41416-018-0319-z) (PMID:30420616) (PMCID:PMC6265336)
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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: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Allan, Ms Karen and Cassidy, Professor James and Paul, Mr James and Mcqueen, Mr John and Robles-Zurita, Dr José and Briggs, Professor Andrew and Boyd, Professor 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 > School of Cancer Sciences College of Medical Veterinary and Life Sciences > School of Health & 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 119(11): 1332-1338 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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