| Title |
The Cost Effectiveness of Docetaxel and Active Symptom Control versus Active Symptom Control Alone for Refractory Oesophagogastric Adenocarcinoma: Economic Analysis of the COUGAR-02 Trial
|
|---|---|
| Published in |
PharmacoEconomics, September 2015
|
| DOI | 10.1007/s40273-015-0324-5 |
| Pubmed ID | |
| Authors |
David M. Meads, Andrea Marshall, Claire T. Hulme, Janet A. Dunn, Hugo E. R. Ford |
| Abstract |
The COUGAR-02 trial recently showed survival and quality-of-life benefits of docetaxel and active symptom control (DXL + ASC) over active symptom control (ASC) alone in patients with refractory oesophagogastric adenocarcinoma. The aim of this study was to conduct an economic evaluation conforming to National Institute for Health and Care Excellence (NICE) technology appraisal guidance to evaluate the cost effectiveness of DXL + ASC versus ASC from the perspective of the English National Health Service (NHS). Cost-utility analyses were conducted using trial data. Utility values were captured using the EQ-5D completed by patients at 3- and 6-weekly intervals, while resource use was captured using nurse-completed report forms and patient reports. Incremental cost-effectiveness ratios (ICERs) were calculated and the main outcome was cost per incremental quality-adjusted life-year (QALY). Nonparametric bootstrapping was conducted to capture sampling uncertainty and to generate a cost-effectiveness acceptability curve (CEAC). The analysis horizon was the trial period (median follow-up 12 months) and no modelling or discounting of future costs and benefits was conducted. Average costs were £9352 and £6218 for DXL + ASC and ASC, respectively, and average QALYs were 0.302 and 0.186, respectively. This yielded an ICER of £27,180 for DXL + ASC. DXL + ASC had a 24 % chance of being cost effective at a £20,000 QALY threshold (lambda) and a mean net monetary benefit of -£821; this rose to 59 % and £332 when the threshold was raised to £30,000. If NICE end-of-life criteria are applied, the probability of cost effectiveness increases to 90 % (at lambda = £50,000). Results were robust to sensitivity analyses. DXL + ASC is likely to be cost effective if an end-of-life premium is applied. Further research should determine the impact of different utility measurement strategies and different chemotherapy delivery modes on estimates of cost effectiveness. |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 37 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 16% |
| Other | 5 | 14% |
| Student > Bachelor | 4 | 11% |
| Student > Master | 4 | 11% |
| Student > Doctoral Student | 2 | 5% |
| Other | 6 | 16% |
| Unknown | 10 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 30% |
| Economics, Econometrics and Finance | 5 | 14% |
| Nursing and Health Professions | 4 | 11% |
| Psychology | 2 | 5% |
| Veterinary Science and Veterinary Medicine | 1 | 3% |
| Other | 2 | 5% |
| Unknown | 12 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 March 2018.
All research outputs
#7,466,608
of 22,826,360 outputs
Outputs from PharmacoEconomics
#844
of 1,817 outputs
Outputs of similar age
#90,175
of 267,016 outputs
Outputs of similar age from PharmacoEconomics
#9
of 16 outputs
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