Economic analysis of a phase III clinical trial evaluating the addition of total androgen suppression to radiation versus radiation alone for locally advanced prostate cancer (Radiation Therapy Oncology Group protocol 86-10)
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
- Department of Medicine, University of Toronto, Toronto, Ontario (Canada)
- Department of Medicine, University Health Network, Toronto, Ontario (Canada)
- Department of Information and Science Technologies, Fox Chase Cancer Center, Philadelphia, PA (United States)
- Department of Population Science, Fox Chase Cancer Center, Philadelphia, PA (United States)
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA (United States)
Purpose: To evaluate the cost-effectiveness of adding hormone therapy to radiation for patients with locally advanced prostate cancer, using a Monte Carlo simulation of a Markov Model. Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 86-10 randomized patients to receive radiation therapy (RT) alone or RT plus total androgen suppression (RTHormones) 2 months before and during RT for the treatment of locally advanced prostate cancer. A Markov model was designed with Data Pro (TreeAge Software, Williamstown, MA). The analysis took a payer's perspective. Transition probabilities from one state of health (i.e., with no disease progression or with hormone-responsive metastatic disease) to another were calculated from published rates pertaining to RTOG 86-10. Patients remained in one state of health for 1 year. Utility values for each health state and treatment were obtained from the literature. Distributions were sampled at random from the treatment utilities according to a second-order Monte Carlo simulation technique. Results: The mean expected cost for the RT-only treatments was $29,240 (range, $29,138-$29,403). The mean effectiveness for the RT-only treatment was 5.48 quality-adjusted life years (QALYs) (range, 5.47-5.50). The mean expected cost for RTHormones was $31,286 (range, $31,058-$31,555). The mean effectiveness was 6.43 QALYs (range, 6.42-6.44). Incremental cost-effectiveness analysis showed RTHormones to be within the range of cost-effectiveness at $2,153/QALY. Cost-effectiveness acceptability curve analysis resulted in a >80% probability that RTHormones is cost-effective. Conclusions: Our analysis shows that adding hormonal treatment to RT improves health outcomes at a cost that is within the acceptable cost-effectiveness range.
- OSTI ID:
- 20702194
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 63, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2005.03.010; PII: S0360-3016(05)00423-2; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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