Three versus six months of adjuvant doublet chemotherapy for patients with colorectal cancer: a multi-country cost-effectiveness and budget impact analysis

Hanna, C. R. et al. (2021) Three versus six months of adjuvant doublet chemotherapy for patients with colorectal cancer: a multi-country cost-effectiveness and budget impact analysis. Clinical Colorectal Cancer, 20(3), pp. 236-244. (doi: 10.1016/j.clcc.2021.04.001) (PMID:33992542)

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Abstract

Introduction: The Short Course Oncology Treatment (SCOT) trial demonstrated non-inferiority, less toxicity and cost-effectiveness from a UK perspective of 3 versus 6 months of oxaliplatin-based chemotherapy for patients with colorectal cancer. This study assessed the cost-effectiveness of shorter treatment, and the budget impact of implementing trial findings from the perspective of all countries that recruited to SCOT: Australia, Denmark, New Zealand, Spain, Sweden and the UK. Methods: Individual cost-utility analyses (CUAs) were performed from the perspective of each country. Resource, quality of life and survival estimates from the SCOT trial (n=6,065) were used. Probabilistic sensitivity analysis and sub-group analyses were undertaken. Using undiscounted costs from these CUAs, the impact on the country specific healthcare budgets of implementing the SCOT trial findings was calculated over a 5-year period. United States dollars were the currency used, with 2019 as base year. One-way and scenario sensitivity analysis addressed uncertainty within the budget impact analysis. Results: Three months of treatment was cost-saving and cost-effective compared to 6 months from the perspective of all countries. The incremental net monetary benefit per patient ranged from $8,972 (Spain) to $13,884 (Denmark). The healthcare budget impact over 5 years for the base case scenario ranged from $3.6 million (New Zealand) to $61.4 million (UK) and totalled over $150 million across all countries. Discussion: This study has widened the transferability of results from the SCOT trial, showing shorter treatment is cost-effective from a multi-country perspective. The vast savings from implementation could fully justify the investment in conducting the SCOT trial.

Item Type:Articles
Additional Information:CRH holds a Clinical Trials Fellowship Grant from CRUK and the University of Glasgow (Grant ID: C61974/A2429) The SCOT trial was supported by funding from the Medical Research Council, National Institute for Health Research, NCRN/SCRN/NIHR infrastructure funding within the participating sites in the UK, the Swedish Cancer Society, Interreg in Denmark and Cancer Research UK Core Clinical Trials Unit funding.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Allan, Ms Karen and Kelly, Mrs Caroline and Jones, Professor Robert and Mcqueen, Mr John and Harkin, Mrs Andrea and Robles-Zurita, Dr Jose Antonio and Briggs, Professor Andrew and Hanna, Catherine and Boyd, Dr Kathleen
Creator Roles:
Hanna, C.Methodology, Software, Formal analysis, Investigation, Writing – review and editing, Visualization, Project administration, Funding acquisition
Robles-Zurita, J. A.Methodology, Software, Formal analysis, Investigation, Supervision, Writing – review and editing, Visualization
Briggs, A.Methodology, Formal analysis, Supervision, Writing – review and editing
Harkin, A.Data curation, Writing – review and editing
Kelly, C.Software, Formal analysis, Supervision, Writing – review and editing
Mcqueen, J.Data curation, Writing – review and editing
Allan, K.Data curation, Writing – review and editing
Jones, R.Methodology, Supervision, Writing – review and editing, Conceptualization, Methodology, Funding acquisition
Boyd, K.Conceptualization, Methodology, Supervision, Writing – review and editing, Funding acquisition
Authors: Hanna, C. R., Robles-Zurita, J. A., Briggs, A., Harkin, A., Kelly, C., McQueen, J., Allan, K., Pearson, S., Hollander, N. H., Glimelius, B., Salazar, R., Segelov, E., Saunders, M., Iveson, T., Jones, R. J., and Boyd, K. A.
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
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Colorectal Cancer
Publisher:Elsevier
ISSN:1533-0028
ISSN (Online):1938-0674
Published Online:15 April 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Clinical Colorectal Cancer 20(3): 236-244
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174279CRUK CTU Glasgow - Clinical Trial FellowshipCatherine HannaCancer Research UK (CRUK)C61974/A24293Institute of Cancer Sciences