IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v24y2023i2d10.1007_s10198-022-01467-5.html
   My bibliography  Save this article

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
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-022-01467-5
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10198-022-01467-5?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Samuel Sebsibie & Workineh Asmare & Tessema Endalkachew, 2015. "Agricultural Technology Adoption and Rural Poverty: a Study on Smallholders in Amhara Regional State, Ethiopia," Ethiopian Journal of Economics, Ethiopian Economics Association, vol. 23(2), December.
    2. Thorvaldur Gylfason & Inmaculada Martínez-Zarzoso & Per Magnus Wijkman, 2015. "Free Trade Agreements, Institutions and the Exports of Eastern Partnership Countries," Journal of Common Market Studies, Wiley Blackwell, vol. 53(6), pages 1214-1229, November.
    3. Patrick Richard & Regine Walker & Pierre Alexandre, 2018. "The burden of out of pocket costs and medical debt faced by households with chronic health conditions in the United States," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-13, June.
    4. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
    5. Schaak, Henning, 2015. "The Impact of Free Trade Agreements on International Agricultural Trade: A Gravity Application on the Dairy Product Trade and the ASEAN-China-FTA," 55th Annual Conference, Giessen, Germany, September 23-25, 2015 211619, German Association of Agricultural Economists (GEWISOLA).
    6. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    7. Anand Acharya & Lynda Khalaf & Marcel Voia & Myra Yazbeck & David Wensley, 2021. "Severity of Illness and the Duration of Intensive Care," Working Papers 2021-003, Human Capital and Economic Opportunity Working Group.
    8. Judite Gonçalves & France Weaver, 2017. "Effects of formal home care on hospitalizations and doctor visits," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 203-233, June.
    9. Head, Keith & Mayer, Thierry, 2014. "Gravity Equations: Workhorse,Toolkit, and Cookbook," Handbook of International Economics, in: Gopinath, G. & Helpman, . & Rogoff, K. (ed.), Handbook of International Economics, edition 1, volume 4, chapter 0, pages 131-195, Elsevier.
    10. Fernández, José-Luis & Kendall, Jeremy & Davey, Vanessa & Knapp, Martin, 2007. "Direct payments in England: factors linked to variations in local provision," LSE Research Online Documents on Economics 15915, London School of Economics and Political Science, LSE Library.
    11. Timothy T. Brown & James C. Robinson, 2016. "Reference Pricing with Endogenous or Exogenous Payment Limits: Impacts on Insurer and Consumer Spending," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 740-749, June.
    12. Keith Davis & Timothy Bell & Jacqueline Miller & Derek Misurski & Bela Bapat, 2011. "Hospital costs, length of stay and mortality associated with childhood, adolescent and young Adult meningococcal disease in the US," Applied Health Economics and Health Policy, Springer, vol. 9(3), pages 197-207, May.
    13. Jasjeet Singh Sekhon & Richard D. Grieve, 2012. "A matching method for improving covariate balance in cost‐effectiveness analyses," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 695-714, June.
    14. J. M. C. Santos Silva & Silvana Tenreyro, 2022. "The Log of Gravity at 15," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 21(3), pages 423-437, September.
    15. Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yu & Qingyue Meng, 2014. "Effects Of Ncms On Access To Care And Financial Protection In China," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 917-934, August.
    16. Carole Roan Gresenz & Jeanette A. Rogowski & Jose Escarce, 2004. "Healthcare Markets, the Safety Net and Access to Care Among the Uninsured," NBER Working Papers 10799, National Bureau of Economic Research, Inc.
    17. Santos Silva, J.M.C. & Tenreyro, Silvana, 2010. "On the existence of the maximum likelihood estimates in Poisson regression," Economics Letters, Elsevier, vol. 107(2), pages 310-312, May.
    18. Partha Deb & Murat K. Munkin & Pravin K. Trivedi, 2006. "Bayesian analysis of the two‐part model with endogeneity: application to health care expenditure," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1081-1099, November.
    19. Onur Başer & Joseph C. Gardiner & Cathy J. Bradley & Hüseyin Yüce & Charles Given, 2006. "Longitudinal analysis of censored medical cost data," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 513-525, May.
    20. repec:hal:spmain:info:hdl:2441/75dbbb2hc596np6q8flqf6i79k is not listed on IDEAS
    21. Natina Yaduma & Mika Kortelainen & Ada Wossink, 2013. "Estimating Mortality and Economic Costs of Particulate Air Pollution in Developing Countries: The Case of Nigeria," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 54(3), pages 361-387, March.

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:24:y:2023:i:2:d:10.1007_s10198-022-01467-5. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.