Long‐term hormone therapy and radiation is cost‐effective for patients with locally advanced prostate carcinoma

Konski, André; Bruner, Deborah Watkins; Brereton, Harmar D.; Feigenberg, Steven J.; Hanks, Gerald E.

doi:10.1002/cncr.21575

Cited by 27 publications

(15 citation statements)

References 26 publications

(37 reference statements)

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“…Though studies have examined the cost-effectiveness of adjuvant goserelin with radiotherapy for locally advanced prostate cancer [13,14], few have compared the cost-effectiveness of adjuvant goserelin to adjuvant chemotherapy alone in premenopausal breast cancer patients. The present study evaluated the cost-effectiveness of adjuvant goserelin or adjuvant chemotherapy in stage Ia to IIIa ER + breast cancer patients using health related quality of life (HRQoL) data.…”

Section: Introductionmentioning

confidence: 99%

Cost-utility analysis of adjuvant goserelin (Zoladex) and adjuvant chemotherapy in premenopausal women with breast cancer

Cheng¹,

Wang

Uen³

2012

BMC Cancer

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BackgroundIncreased health care costs have made it incumbent on health-care facilities and physicians to demonstrate both clinical and cost efficacy when recommending treatments. Though studies have examined the cost-effectiveness of adjuvant goserelin with radiotherapy for locally advanced prostate cancer, few have compared the cost-effectiveness of adjuvant goserelin to adjuvant chemotherapy alone in premenopausal breast cancer.MethodsIn this retrospective study at one hospital, the records of 152 patients with stage Ia to IIIa ER + breast cancer who received goserelin or chemotherapy were reviewed. Survival analysis was assessed by the Kaplan-Meier method. Patients were interviewed to evaluate their quality of life using the European Organization for Research and Treatment Quality of Life questionnaire (EORTC-QLQ-C30, version 4.0), and to obtain the utility value by the standard gamble (SG) and visual scale (VS) methods. Total medical cost was assessed from the (National Health Insurance) NHI payer's perspective.ResultsSurvival at 11 years was significantly better in the groserelin group (P < 0.0012). The lifetime lost was lower in the goserelin group (42 months vs. 66 months). The quality adjusted survival (QAS) of patients who received goserelin was longer (122.5 ± 6.3 vs. 112.2 ± 6.7 months). Total expenses of goserelin were more than cyclophosphamide, methotrexate, 5-fluorouracil (CMF) or 5-fluorouracil, epirubicin, cyclophosphamide (FEC) chemotherapy regimes, but less than docetaxel, epirubicin (TE) or docetaxel, epirubicin, cyclophosphamide (TEC) regimes. The quality-adjusted life-year was higher in the goserelin group.ConclusionsGoserelin therapy results in better survival and higher utility-weighted life-years, and is more cost-effective than TC or TEC chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Cost-utility analysis of adjuvant goserelin (Zoladex) and adjuvant chemotherapy in premenopausal women with breast cancer

Cheng¹,

Wang

Uen³

2012

BMC Cancer

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“…Hormone therapy is used in the treatment of advanced-stage prostate cancer and, based on evidence for improved outcomes, hormone therapy is now also being used in the treatment of patients without distant metastases including men with locally advanced, node positive, or biochemically recurrent disease [1,2]. Because these patients typically have a life expectancy of 10 years or more on these treatments, the impact on quality of life has become an important treatment consideration [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Prospective study of depression and fatigue in men with advanced prostate cancer receiving hormone therapy

Pirl¹,

Greer²,

Goode³

et al. 2007

Psycho-Oncology

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Purpose-We prospectively examined the development of depressive symptoms and fatigue among men with locally advanced prostate cancer receiving hormone therapy.Methods-Fifty-two men with advanced or recurrent prostate cancer were randomly assigned to receive either parenteral leuprolide or oral bicalutamide. Patients completed the Beck Depression Inventory (BDI) and Fatigue Severity Scale (FSS) at pretreatment baseline, 6 months, and 12 months.Results-Rates of at least mild depression ranged from 10.4 to 16.3% over the 12 months and were not significantly different at each time point. Mean change in BDI scores from baseline to 6 months for the entire sample was 0.91 (SE = 0.73), and from baseline to 12 months was 0.35 (SE = 0.67). Mean FSS scores increased significantly from baseline (M = 24.43; SD = 11.75) to 6 months (M = 27.93; SD = 13.52) and remained steady at 12 months (M = 27.80; SD = 14.44). There were no significant differences in depression between the two types of hormone therapy.Conclusion-Hormone therapy does not appear to cause clinically significant changes in depression among men with locally advanced prostate cancer. However, fatigue increased significantly over the study period.

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“…20,21 Performing economic analyses alongside clinical trials is challenging since clinical outcomes and priorities may differ from economic outcomes. [22][23][24] This economic analysis fulfilled the majority of criteria supporting an economic analysis of a clinical trial outlined by Hillner.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of using administrative claims data for cost-effectiveness analysis of a clinical trial

Konski

Bhargavan

Owen

et al. 2008

Journal of Medical Economics

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Objective-This study was performed retrospectively to determine if Medicare claims data could be used to evaluate the cost-effectiveness, from a payer perspective, of different radiation treatment schedules evaluated in a national clinical trial.Methods-Medicare costs from all providers and all places of service were obtained from the Centers for Medicare & Medicaid Services (CMS) for patients treated from 1992-1996 on Radiation Therapy Oncology Group (RTOG) 90-03, and combined with data on outcomes from the trial.Results-Of the 1113 patients entered, Medicare cost data and clinical outcomes were available for 187 patients. Significant differences in tolerance of treatment and outcome were noted between patients with Medicare data included in the study and patients without Medicare data and nonMedicare patients excluded form it. Ninety-five percent confidence ellipses on the incremental costeffectiveness scatterplots crossed both axes, indicating non-significant differences in costeffectiveness between radiation treatment schedules.Conclusions-Claims data permit estimation of cost-effectiveness, but Medicare data provide inadequate representation of results applicable to patients from the general population.

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Long‐term hormone therapy and radiation is cost‐effective for patients with locally advanced prostate carcinoma

Cited by 27 publications

References 26 publications

Cost-utility analysis of adjuvant goserelin (Zoladex) and adjuvant chemotherapy in premenopausal women with breast cancer

Cost-utility analysis of adjuvant goserelin (Zoladex) and adjuvant chemotherapy in premenopausal women with breast cancer

Prospective study of depression and fatigue in men with advanced prostate cancer receiving hormone therapy

Feasibility of using administrative claims data for cost-effectiveness analysis of a clinical trial

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