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

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

Background: 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 perspectives of all countries recruited to SCOT: Australia, Denmark, New Zealand, Spain, Sweden, and the United Kingdom. Patients and Methods: Individual cost–utility analyses were performed from the perspective of each country. Resource, quality of life, and survival estimates from the SCOT trial (N = 6065) were used. Probabilistic sensitivity analysis and subgroup analyses were undertaken. Using undiscounted costs from these cost–utility analyses, the impact on country-specific healthcare budgets of implementing the SCOT trial findings was calculated over a 5-year period. The currency used was US dollars (US$), and 2019 was the base year. One-way and scenario sensitivity analysis addressed uncertainty within the budget impact analysis. Results: Three months of treatment were cost saving and cost-effective compared to 6 months from the perspective of all countries. The incremental net monetary benefit per patient ranged from US$8972 (Spain) to US$13,884 (Denmark). The healthcare budget impact over 5 years for the base-case scenario ranged from US$3.6 million (New Zealand) to US$61.4 million (UK) and totaled over US$150 million across all countries. Conclusion: This study has widened the transferability of results from the SCOT trial, showing that 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.

Clinical trial, Cost analysis, Drug therapy, International, Neoplasm
1533-0028
236-244
Hanna, Catherine R.
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Robles-Zurita, Jose A.
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Briggs, Andrew
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Harkin, Andrea
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Kelly, Caroline
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McQueen, John
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Allan, Karen
ffefc020-08ff-4f35-94de-e8c580acbace
Pearson, Sarah
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Hollander, Henrik
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Glimelius, Bengt
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Salazar, Ramon
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Segelov, Eva
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Saunders, Mark
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Iveson, Tim
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Jones, Robert J.
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Boyd, Kathleen A.
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Hanna, Catherine R.
b451f1b8-3031-4b83-885c-5aa6c1b60064
Robles-Zurita, Jose A.
5b0d9688-5d8b-4ceb-bbb5-395744279b50
Briggs, Andrew
82c19e42-e08b-44e8-bd15-117b80a548cb
Harkin, Andrea
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Kelly, Caroline
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McQueen, John
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Allan, Karen
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Pearson, Sarah
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Hollander, Henrik
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Glimelius, Bengt
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Salazar, Ramon
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Segelov, Eva
72e48118-013a-42ae-b138-c0720c813f67
Saunders, Mark
a0ce53d6-19e2-440b-becb-4545ad086f16
Iveson, Tim
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Jones, Robert J.
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Boyd, Kathleen A.
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Hanna, Catherine R., Robles-Zurita, Jose A., Briggs, Andrew, Harkin, Andrea, Kelly, Caroline, McQueen, John, Allan, Karen, Pearson, Sarah, Hollander, Henrik, Glimelius, Bengt, Salazar, Ramon, Segelov, Eva, Saunders, Mark, Iveson, Tim, Jones, Robert J. and Boyd, Kathleen A. (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), 236-244. (doi:10.1016/j.clcc.2021.04.001).

Record type: Article

Abstract

Background: 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 perspectives of all countries recruited to SCOT: Australia, Denmark, New Zealand, Spain, Sweden, and the United Kingdom. Patients and Methods: Individual cost–utility analyses were performed from the perspective of each country. Resource, quality of life, and survival estimates from the SCOT trial (N = 6065) were used. Probabilistic sensitivity analysis and subgroup analyses were undertaken. Using undiscounted costs from these cost–utility analyses, the impact on country-specific healthcare budgets of implementing the SCOT trial findings was calculated over a 5-year period. The currency used was US dollars (US$), and 2019 was the base year. One-way and scenario sensitivity analysis addressed uncertainty within the budget impact analysis. Results: Three months of treatment were cost saving and cost-effective compared to 6 months from the perspective of all countries. The incremental net monetary benefit per patient ranged from US$8972 (Spain) to US$13,884 (Denmark). The healthcare budget impact over 5 years for the base-case scenario ranged from US$3.6 million (New Zealand) to US$61.4 million (UK) and totaled over US$150 million across all countries. Conclusion: This study has widened the transferability of results from the SCOT trial, showing that 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.

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Accepted/In Press date: 1 April 2021
Published date: 15 April 2021
Keywords: Clinical trial, Cost analysis, Drug therapy, International, Neoplasm

Identifiers

Local EPrints ID: 453376
URI: http://eprints.soton.ac.uk/id/eprint/453376
ISSN: 1533-0028
PURE UUID: 97675a28-c35e-4a5d-8d42-6dc2ed659e2a
ORCID for Tim Iveson: ORCID iD orcid.org/0000-0002-4681-2712

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Date deposited: 13 Jan 2022 18:17
Last modified: 18 Mar 2024 02:47

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Contributors

Author: Catherine R. Hanna
Author: Jose A. Robles-Zurita
Author: Andrew Briggs
Author: Andrea Harkin
Author: Caroline Kelly
Author: John McQueen
Author: Karen Allan
Author: Sarah Pearson
Author: Henrik Hollander
Author: Bengt Glimelius
Author: Ramon Salazar
Author: Eva Segelov
Author: Mark Saunders
Author: Tim Iveson ORCID iD
Author: Robert J. Jones
Author: Kathleen A. Boyd

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