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, (doi: 10.1016/j.clcc.2021.04.001) (In Press)

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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:In Press
Refereed:Yes
Glasgow Author(s) Enlighten ID:Allan, Ms Karen and Robles-Zurita, Dr Jose Antonio and Briggs, Professor Andrew and Jones, Professor Robert and Hanna, Catherine and Mcqueen, Mr John and Boyd, Dr Kathleen and Kelly, Mrs Caroline and Harkin, Mrs Andrea
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 2021
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