SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer

Authors: Robles-Zurita, J., Boyd, K.A., Briggs, A.H., Iveson, T., Kerr, R.S., Saunders, M.P., Cassidy, J., Hollander, N.H., 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, 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., Paul, J.

Journal: British Journal of Cancer

Publication Date: 27/11/2018

Volume: 119

Issue: 11

Pages: 1332-1338

eISSN: 1532-1827

ISSN: 0007-0920

DOI: 10.1038/s41416-018-0319-z

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.

https://eprints.bournemouth.ac.uk/31549/

Source: Scopus

SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer.

Authors: Robles-Zurita, J., Boyd, K.A., Briggs, A.H., Iveson, T., Kerr, R.S., Saunders, M.P., Cassidy, J., Hollander, N.H., 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, 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., Paul, J.

Journal: Br J Cancer

Publication Date: 11/2018

Volume: 119

Issue: 11

Pages: 1332-1338

eISSN: 1532-1827

DOI: 10.1038/s41416-018-0319-z

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.

https://eprints.bournemouth.ac.uk/31549/

Source: PubMed

SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer

Authors: Robles-Zurita, J., Boyd, K.A., Briggs, A.H., Iveson, T., Kerr, R.S., Saunders, M.P., Cassidy, J., Hollander, N.H., 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, 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., Paul, J.

Journal: BRITISH JOURNAL OF CANCER

Publication Date: 27/11/2018

Volume: 119

Issue: 11

Pages: 1332-1338

eISSN: 1532-1827

ISSN: 0007-0920

DOI: 10.1038/s41416-018-0319-z

https://eprints.bournemouth.ac.uk/31549/

Source: Web of Science

SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer.

Authors: Robles-Zurita, J., Boyd, K.A., Briggs, A.H., Iveson, T., Kerr, R.S., Saunders, M.P., Cassidy, J., Hollander, N.H., 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, 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., Paul, J.

Journal: British journal of cancer

Publication Date: 11/2018

Volume: 119

Issue: 11

Pages: 1332-1338

eISSN: 1532-1827

ISSN: 0007-0920

DOI: 10.1038/s41416-018-0319-z

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.

https://eprints.bournemouth.ac.uk/31549/

Source: Europe PubMed Central