Andronis, L., Goranitis, I., Pirrie, S. et al. (19 more authors) (2016) Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747). BJU International. ISSN 1464-4096
Abstract
Objective To evaluate the cost-effectiveness of adding zoledronic acid orstrontium-89 to standard docetaxel chemotherapy for patientswith castrate-refractory prostate cancer (CRPC).
Patients and methods Data on resource use and quality of life for 707 patientscollected prospectively in the TRAPEZE 2 9 2 factorialrandomised trial (ISRCTN 12808747) were used to assess thecost-effectiveness of i) zoledronic acid versus no zoledronicacid (ZA vs. no ZA), and ii) strontium-89 versus nostrontium-89 (Sr89 vs. no Sr89). Costs were estimated fromthe perspec tive of the National Health Service in the UK andincluded expenditures for trial treatments, concomitantmedications, and use of related hospital and primary careservices. Q uality-adjusted life-years (QALYs) were calculatedaccording to patients’ responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results areexpress ed as incremental cost-effectiveness ratios (ICERs) andcost-effectiveness acceptability curves.
Results The per-patient cost for ZA was £12 66 7, £251 higher than theequivalent cost in the no ZA group. Patients in the ZA grouphad on average 0.03 QALYs more than their counterparts in noZA group. The ICER for this comparison was £8 005. Sr89 wasassociated with a cost of £13 230 , £1365 higher than no Sr89,and a gain of 0.08 QALYs compared to no Sr89. The ICER forSr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.
Conclusions The addition of bone-targeting treatments to standardchemotherapy led to a small improvement in QALYs for amodest increase in cost (or cost-savings). ZA and Sr89resulted in ICERs below conventional willingness-to-pa y perQALY thresholds, suggesting that their addition tochemotherapy may represent a cost-effective use of resources.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2016 The Authors. published by John Wiley & Sons Ltd on behalf of BJU International. www.bjui.org This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
Keywords: | castrate-refractory prostate cancer; cost-effectiveness analysis; quality of life; bone protecting treatments; zoledronic acid; Sr89 |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology and Metabolism (Sheffield) The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 07 Sep 2016 10:30 |
Last Modified: | 07 Sep 2016 10:30 |
Published Version: | http://dx.doi.org/10.1111/bju.13549 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/bju.13549 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:104430 |
Download
Filename: Andronis_et_al-2016-BJU_International.pdf
Licence: CC-BY-NC-ND 4.0