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Is ultra-hypo-fractionated radiotherapy more cost-effective relative to conventional fractionation in treatment of prostate cancer? A cost–utility analysis alongside a randomized HYPO-RT-PC trial

Author

Listed:
  • Sun Sun

    (Umeå University
    Karolinska Institutet
    Shandong University)

  • Håkan Jonsson

    (Umeå University)

  • Klas-Göran Salén

    (Umeå University)

  • Mats Andén

    (Kalmar Hospital)

  • Lars Beckman

    (Sundsvall Hospital)

  • Per Fransson

    (Umeå University
    Umeå University)

Abstract

Background Economic evidence for comparing low fraction with ultra-hypo fractionated (UHF) radiation therapy in the treatment of intermediate-to-high-risk prostate cancer (PC) is lacking, especially in Europe. This study presents an economic evaluation performed alongside an ongoing clinical trial. Aim To investigate up to 6 years’ follow-up whether conventional fractionation (CF, 78.0 Gy in 39 fractions, 5 days per week for 8 weeks) is more cost-effective than UHF (42.7 Gy in 7 fractions, 3 days per week for 2.5 weeks inclusive of 2 weekends) radiotherapy in treatment for patients with intermediate-to-high-risk PC. Method HYPO-RT-PC trial is an open-label, randomized, multicenter (10 in Sweden; 2 in Denmark) phase-3 trial. Patients from Sweden (CF 434; UHF 445) were included in this study. The trial database was linked to the National Patient Registry (NPR). Costs for inpatient/non-primary outpatient care for each episode were retrieved. For calculating Quality-adjusted life years (QALYs), the EORTC QLQ-C30 questionnaire was mapped to the EQ-5D-3L index. Multivariable regression analyses were used to compare the difference in costs and QALYs, adjusting for age and baseline costs, and health status. The confidence interval for the difference in costs, QALYs and incremental cost-effectiveness ratio effectiveness ratio (ICER) was estimated by the bootstrap percentile method. Results No significant differences were found in ICER between the two arms after 6 years of follow-up. Conclusion The current study did not support that the ultra-hypo-fractionated treatment was more cost-effective than the conventional fraction treatment up to the sixth year of the trial.

Suggested Citation

  • Sun Sun & Håkan Jonsson & Klas-Göran Salén & Mats Andén & Lars Beckman & Per Fransson, 2023. "Is ultra-hypo-fractionated radiotherapy more cost-effective relative to conventional fractionation in treatment of prostate cancer? A cost–utility analysis alongside a randomized HYPO-RT-PC trial," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(2), pages 237-246, March.
    • Handle: RePEc:spr:eujhec:v:24:y:2023:i:2:d:10.1007_s10198-022-01467-5
    DOI: 10.1007/s10198-022-01467-5
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    References listed on IDEAS

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    1. Linnea Polgreen & John Brooks, 2012. "Estimating Incremental Costs with Skew," Applied Health Economics and Health Policy, Springer, vol. 10(5), pages 319-329, September.
    2. Neha Amin & David Sher & Andre Konski, 2014. "Systematic Review of the Cost Effectiveness of Radiation Therapy for Prostate Cancer from 2003 to 2013," Applied Health Economics and Health Policy, Springer, vol. 12(4), pages 391-408, August.
    3. Kristina Burström & Fitsum Sebsibe Teni & Ulf-G. Gerdtham & Reiner Leidl & Gert Helgesson & Ola Rolfson & Martin Henriksson, 2020. "Experience-Based Swedish TTO and VAS Value Sets for EQ-5D-5L Health States," PharmacoEconomics, Springer, vol. 38(8), pages 839-856, August.
    4. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
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    More about this item

    Keywords

    Cost–utility analysis; Prostate cancer; Within-trial economic evaluation; Radiotherapy; Intermediate-to-high-risk cancer;
    All these keywords.

    JEL classification:

    • I19 - Health, Education, and Welfare - - Health - - - Other

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