Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)

Lazaros Andronis; Ilias Goranitis; Sarah Pirrie; Ann Pope; Darren Barton; Stuart Collins; Adam Daunton; Duncan McLaren; Joe M O'Sullivan; Chris Parker; Emilio Porfiri; John Staffurth; Andrew Stanley; James Wylie; Sharon Beesley; Alison Birtle; Janet E Brown; Prabir Chakraborti; Syed A Hussain; J Martin Russell; Lucinda J Billingham; Nicholas D James

doi:10.1111/bju.13549

Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)

Lazaros Andronis, Ilias Goranitis, Sarah Pirrie, Ann Pope, Darren Barton, Stuart Collins, Adam Daunton, Duncan McLaren, Joe M O'Sullivan, Chris Parker, Emilio Porfiri, John Staffurth, Andrew Stanley, James Wylie, Sharon Beesley, Alison Birtle, Janet E Brown, Prabir Chakraborti, Syed A Hussain, J Martin RussellLucinda J Billingham, Nicholas D James

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11 Citations (Scopus)

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Abstract

OBJECTIVE: To evaluate the cost-effectiveness of adding zoledronic acid or strontium-89 to standard docetaxel chemotherapy for patients with castrate-refractory prostate cancer (CRPC).

PATIENTS AND METHODS: Data on resource use and quality of life for 707 patients collected prospectively in the TRAPEZE 2 × 2 factorial randomised trial (ISRCTN 12808747) were used to assess the cost-effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium-89 versus no strontium-89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in the UK and included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality-adjusted life-years (QALYs) were calculated according to patients' responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results are expressed as incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves.

RESULTS: The per-patient cost for ZA was £12 667, £251 higher than the equivalent cost in the no ZA group. Patients in the ZA group had on average 0.03 QALYs more than their counterparts in no ZA group. The ICER for this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08 QALYs compared to no Sr89. The ICER for Sr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.

CONCLUSIONS: The addition of bone-targeting treatments to standard chemotherapy led to a small improvement in QALYs for a modest increase in cost (or cost-savings). ZA and Sr89 resulted in ICERs below conventional willingness-to-pay per QALY thresholds, suggesting that their addition to chemotherapy may represent a cost-effective use of resources.

Original language	English
Pages (from-to)	522-529
Number of pages	8
Journal	BJU international
Volume	119
Issue number	4
Early online date	3 Jun 2016
DOIs	https://doi.org/10.1111/bju.13549 https://doi.org/10.1111/bju.13549
Publication status	Published - Apr 2017

Keywords

castrate-refractory prostate cancer
cost-effectiveness analysis
quality of ilife
bone protecting treatments
zoledronic acid
strontium-89

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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TRAPEZE: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of chemotherapy with zoledronic acid, strontium-89, or both, in men with bony metastatic castration-refractory prostate cancer: Clinical Trial Report
James, N., Pirrie, S., Pope, A., Barton, D., Andronis, L., Goranitis, I., Collins, S., McLaren, D., O'Sullivan, J., Parker, C., Porfiri, E., Staffurth, J., Stanley, A., Wylie, J., Beesley, S., Birtle, A., Brown, J., Chakraborti, P., Russell, M. & Billingham, L., 31 Jul 2016, In: Health Technology Assessment. 20, 53, 20530.
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18 Citations (Scopus)

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Andronis, L., Goranitis, I., Pirrie, S., Pope, A., Barton, D., Collins, S., Daunton, A., McLaren, D., O'Sullivan, J. M., Parker, C., Porfiri, E., Staffurth, J., Stanley, A., Wylie, J., Beesley, S., Birtle, A., Brown, J. E., Chakraborti, P., Hussain, S. A., ... James, N. D. (2017). Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747). BJU international, 119(4), 522-529. Advance online publication. https://doi.org/10.1111/bju.13549, https://doi.org/10.1111/bju.13549

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title = "Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)",

abstract = "OBJECTIVE: To evaluate the cost-effectiveness of adding zoledronic acid or strontium-89 to standard docetaxel chemotherapy for patients with castrate-refractory prostate cancer (CRPC).PATIENTS AND METHODS: Data on resource use and quality of life for 707 patients collected prospectively in the TRAPEZE 2 × 2 factorial randomised trial (ISRCTN 12808747) were used to assess the cost-effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium-89 versus no strontium-89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in the UK and included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality-adjusted life-years (QALYs) were calculated according to patients' responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results are expressed as incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves.RESULTS: The per-patient cost for ZA was £12 667, £251 higher than the equivalent cost in the no ZA group. Patients in the ZA group had on average 0.03 QALYs more than their counterparts in no ZA group. The ICER for this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08 QALYs compared to no Sr89. The ICER for Sr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.CONCLUSIONS: The addition of bone-targeting treatments to standard chemotherapy led to a small improvement in QALYs for a modest increase in cost (or cost-savings). ZA and Sr89 resulted in ICERs below conventional willingness-to-pay per QALY thresholds, suggesting that their addition to chemotherapy may represent a cost-effective use of resources.",

keywords = "castrate-refractory prostate cancer, cost-effectiveness analysis, quality of ilife, bone protecting treatments, zoledronic acid, strontium-89",

author = "Lazaros Andronis and Ilias Goranitis and Sarah Pirrie and Ann Pope and Darren Barton and Stuart Collins and Adam Daunton and Duncan McLaren and O'Sullivan, {Joe M} and Chris Parker and Emilio Porfiri and John Staffurth and Andrew Stanley and James Wylie and Sharon Beesley and Alison Birtle and Brown, {Janet E} and Prabir Chakraborti and Hussain, {Syed A} and Russell, {J Martin} and Billingham, {Lucinda J} and James, {Nicholas D}",

year = "2017",

month = apr,

doi = "10.1111/bju.13549",

language = "English",

volume = "119",

pages = "522--529",

journal = "BJU international",

issn = "1464-4096",

publisher = "Wiley",

number = "4",

}

Andronis, L, Goranitis, I, Pirrie, S, Pope, A, Barton, D, Collins, S, Daunton, A, McLaren, D, O'Sullivan, JM, Parker, C, Porfiri, E, Staffurth, J, Stanley, A, Wylie, J, Beesley, S, Birtle, A, Brown, JE, Chakraborti, P, Hussain, SA, Russell, JM, Billingham, LJ & James, ND 2017, 'Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)', BJU international, vol. 119, no. 4, pp. 522-529. https://doi.org/10.1111/bju.13549, https://doi.org/10.1111/bju.13549

Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747). / Andronis, Lazaros; Goranitis, Ilias; Pirrie, Sarah et al.
In: BJU international, Vol. 119, No. 4, 04.2017, p. 522-529.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer

T2 - results from the TRAPEZE trial (ISRCTN 12808747)

AU - Andronis, Lazaros

AU - Goranitis, Ilias

AU - Pirrie, Sarah

AU - Pope, Ann

AU - Barton, Darren

AU - Collins, Stuart

AU - Daunton, Adam

AU - McLaren, Duncan

AU - O'Sullivan, Joe M

AU - Parker, Chris

AU - Porfiri, Emilio

AU - Staffurth, John

AU - Stanley, Andrew

AU - Wylie, James

AU - Beesley, Sharon

AU - Birtle, Alison

AU - Brown, Janet E

AU - Chakraborti, Prabir

AU - Hussain, Syed A

AU - Russell, J Martin

AU - Billingham, Lucinda J

AU - James, Nicholas D

PY - 2017/4

Y1 - 2017/4

N2 - OBJECTIVE: To evaluate the cost-effectiveness of adding zoledronic acid or strontium-89 to standard docetaxel chemotherapy for patients with castrate-refractory prostate cancer (CRPC).PATIENTS AND METHODS: Data on resource use and quality of life for 707 patients collected prospectively in the TRAPEZE 2 × 2 factorial randomised trial (ISRCTN 12808747) were used to assess the cost-effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium-89 versus no strontium-89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in the UK and included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality-adjusted life-years (QALYs) were calculated according to patients' responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results are expressed as incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves.RESULTS: The per-patient cost for ZA was £12 667, £251 higher than the equivalent cost in the no ZA group. Patients in the ZA group had on average 0.03 QALYs more than their counterparts in no ZA group. The ICER for this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08 QALYs compared to no Sr89. The ICER for Sr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.CONCLUSIONS: The addition of bone-targeting treatments to standard chemotherapy led to a small improvement in QALYs for a modest increase in cost (or cost-savings). ZA and Sr89 resulted in ICERs below conventional willingness-to-pay per QALY thresholds, suggesting that their addition to chemotherapy may represent a cost-effective use of resources.

AB - OBJECTIVE: To evaluate the cost-effectiveness of adding zoledronic acid or strontium-89 to standard docetaxel chemotherapy for patients with castrate-refractory prostate cancer (CRPC).PATIENTS AND METHODS: Data on resource use and quality of life for 707 patients collected prospectively in the TRAPEZE 2 × 2 factorial randomised trial (ISRCTN 12808747) were used to assess the cost-effectiveness of i) zoledronic acid versus no zoledronic acid (ZA vs. no ZA), and ii) strontium-89 versus no strontium-89 (Sr89 vs. no Sr89). Costs were estimated from the perspective of the National Health Service in the UK and included expenditures for trial treatments, concomitant medications, and use of related hospital and primary care services. Quality-adjusted life-years (QALYs) were calculated according to patients' responses to the generic EuroQol EQ-5D-3L instrument, which evaluates health status. Results are expressed as incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves.RESULTS: The per-patient cost for ZA was £12 667, £251 higher than the equivalent cost in the no ZA group. Patients in the ZA group had on average 0.03 QALYs more than their counterparts in no ZA group. The ICER for this comparison was £8 005. Sr89 was associated with a cost of £13 230, £1365 higher than no Sr89, and a gain of 0.08 QALYs compared to no Sr89. The ICER for Sr89 was £16 884. The probabilities of ZA and Sr89 being cost-effective were 0.64 and 0.60, respectively.CONCLUSIONS: The addition of bone-targeting treatments to standard chemotherapy led to a small improvement in QALYs for a modest increase in cost (or cost-savings). ZA and Sr89 resulted in ICERs below conventional willingness-to-pay per QALY thresholds, suggesting that their addition to chemotherapy may represent a cost-effective use of resources.

KW - castrate-refractory prostate cancer

KW - cost-effectiveness analysis

KW - quality of ilife

KW - bone protecting treatments

KW - zoledronic acid

KW - strontium-89

U2 - 10.1111/bju.13549

DO - 10.1111/bju.13549

M3 - Article

C2 - 27256016

SN - 1464-4096

VL - 119

SP - 522

EP - 529

JO - BJU international

JF - BJU international

IS - 4

ER -

Andronis L, Goranitis I, Pirrie S, Pope A, Barton D, Collins S et al. Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747). BJU international. 2017 Apr;119(4):522-529. Epub 2016 Jun 3. doi: 10.1111/bju.13549, 10.1111/bju.13549

Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)

Abstract

Keywords

UN SDGs

Access to Document

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TRAPEZE: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of chemotherapy with zoledronic acid, strontium-89, or both, in men with bony metastatic castration-refractory prostate cancer: Clinical Trial Report

[Linked to RGKX13006]A Randomised Phase III Study of Docetaxel (Taxotere) plus Prednisolone vs Docetaxel plus Prednisolone plus Zoledronic acid (Zometa) vs docetaxel plus Prednisolone plus Strontium-89 vs Docetaxel plus prednisolone plus

A Randomised Phase II Feasibility Study of Docetaxel plus Prednisolone vs Docetaxel plus Prednisolone plus Zoledronic acid vs docetaxel plus Prednisolone plus Strontium-89 vs Docetaxel plus prednisolone plus Zoledronic acid plus Strontium-8

Cite this

Cost-effectiveness of zoledronic acid and strontium-89 as bone protecting treatments in addition to chemotherapy in patients with metastatic castrate-refractory prostate cancer: results from the TRAPEZE trial (ISRCTN 12808747)

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Research output

TRAPEZE: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of chemotherapy with zoledronic acid, strontium-89, or both, in men with bony metastatic castration-refractory prostate cancer: Clinical Trial Report

Projects

[Linked to RGKX13006]A Randomised Phase III Study of Docetaxel (Taxotere) plus Prednisolone vs Docetaxel plus Prednisolone plus Zoledronic acid (Zometa) vs docetaxel plus Prednisolone plus Strontium-89 vs Docetaxel plus prednisolone plus

A Randomised Phase II Feasibility Study of Docetaxel plus Prednisolone vs Docetaxel plus Prednisolone plus Zoledronic acid vs docetaxel plus Prednisolone plus Strontium-89 vs Docetaxel plus prednisolone plus Zoledronic acid plus Strontium-8

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