Russell HV, Chi YY, Okcu MF, Bernhardt MB, Rodriguez-Galindo C, Gupta AA, Hawkins DS. Rising drug cost impacts on cost-effectiveness of 2 chemotherapy regimens for intermediate-risk rhabdomyosarcoma: A report from the Children’s Oncology Group. Cancer. 2022 Jan 15;128(2):317-325. doi: 10.1002/cncr.33917. Epub 2021 Oct 8. PubMed PMID: 34623638; PubMed Central PMCID: PMC8738099.
Study ID Citation
Abstract
The Children’s Oncology Group clinical trial for intermediate risk rhabdomyosarcoma randomized participants to a combination of vincristine, dactinomycin, and cyclophosphamide (VAC) alone or VAC alternating with vincristine plus irinotecan (VAC/VI). Clinical outcomes were similar but toxicity profiles differed. This study estimates the cost differences between arms from the health care system’s perspective. A decision-analytic model was used to estimate the incremental cost-effectiveness ratio (ICER) of VAC versus VAC/VI. Protocol-required or recommended medications and laboratory studies were included. Costs were obtained from national databases or supporting literature and inflated to 2019 US$. Demographic and outcome data were obtained from the clinical trial and directed chart reviews. Life-years (LY) were estimated from life expectancy tables and discounted by 3% annually. Probabilistic sensitivity analyses and alternative clinical scenarios identified factors driving costs.