Cost-utility analysis of adjuvant chemotherapy after concurrent chemoradiation in patients with locally advanced cervical cancer.

Autor: Rongsriyam K; Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Tangjitgamol S; Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Leelahavarong P; Heath Intervention and Technology Assessment Program, Nonthaburi, Thailand., Teerawattananon Y; Heath Intervention and Technology Assessment Program, Nonthaburi, Thailand., Tharavichitkul E; Department of Radiology, Faculty of Medicine Chiang, Mai University, Chiang Mai, Thailand., Tovanabutra C; Radiation Oncology Section, Chonburi Cancer Hospital, Chonburi, Thailand., Asakij T; Radiation Oncology Section, Lampang Cancer Hospital, Lampang, Thailand., Paengchit K; Gynecologic Oncology Section, Lampang Cancer Hospital, Lampang, Thailand., Sukhaboon J; Radiation Oncology Section, Lopburi Cancer Hospital, Lopburi, Thailand., Penpattanagul S; Radiation Oncology Section, Udonthani Cancer Hospital, Udonthani, Thailanl, Thailand., Kridakara LCA; Radiation Oncology Section, Bhumibol Adulyadej Hospital, Bangkok, Thailand., Hanprasertpong J; Department of Obstetrics and Gynecology, Prince of Songkla University, Songkla, Thailand., Khunnarong J; Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Chottetanaprasith T; Radiation Oncology Section, Ubonratchathani Cancer Hospital, Ubonratchathani, Thailand., Lorvidhaya V; Department of Radiology, Faculty of Medicine Chiang, Mai University, Chiang Mai, Thailand.; Radiation Oncology Section, Chonburi Cancer Hospital, Chonburi, Thailand.
Jazyk: angličtina
Zdroj: Journal of medical imaging and radiation oncology [J Med Imaging Radiat Oncol] 2020 Dec; Vol. 64 (6), pp. 873-881. Date of Electronic Publication: 2020 Sep 26.
DOI: 10.1111/1754-9485.13103
Abstrakt: Introduction: This study aimed to compare the cost utility of concurrent chemoradiation (CCRT) to CCRT followed by adjuvant chemotherapy (CCRT/ACT) in locally advanced cervical cancer (LACC) using provider and societal viewpoints.
Methods: Data from our trial which was a multi-centre study evaluating the efficacy of ACT compared to CCRT/ACT were entered into a decision tree model. The data included clinical probability, direct medical and non-medical costs, and utility obtained from the patients. The total cost, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICER) were estimated for a time horizon of 3 years. All costs and outcomes were discounted at 3% annually.
Results: The cost of CCRT and CCRT/ACT was approximately 3,058 and 6,896 USD and 4,309 and 7,480 USD from provider and from societal viewpoints, respectively. The QALYs for CCRT and CCRT/ACT were 2.31480 and 2.32045, respectively. The ICER was 569,575 USD per QALY. For stage III-IVA LACC, the ICER was 28,050 USD per QALY. In the sensitivity analysis, the cost of ACT was the most significant influential parameter on the ICER. The ICER would be 0.26-fold lower if the cost of ACT was reduced by 25%. At the current ceiling threshold of 5,000 USD/QALY, CCRT had a 100% probability of being the best option.
Conclusions: In the Thai context, CCRT is more cost effective than CCRT/ACT for stage IIB-IVA LACC. CCRT/ACT may be considered only for stage III-IVA LACC because it has a lower ICER than other types of LACC.
(© 2020 The Royal Australian and New Zealand College of Radiologists.)
Databáze: MEDLINE
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