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The RTOG Outcomes Model: economic end points and measures
Andre Konski1, Deborah Watkins-Bruner,
1Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. a-konski@fccc.edu
Expert Opinion on Pharmacotherapy
|March 12, 2004
Summary
The Radiation Therapy Oncology Group developed an Outcomes Model to assess clinical trials, focusing on economic impact. Economic analyses show that certain cancer treatments offer cost-effective value for patients.
Area of Science:
- Health Economics
- Oncology
- Clinical Trial Analysis
Background:
- Economic evaluations are crucial for understanding the value of clinical trials.
- The Radiation Therapy Oncology Group (RTOG) established an Outcomes Model to assess clinical, humanistic, and economic endpoints.
- The RTOG Economic Impact Committee was formed in 1994 to analyze the economic implications of cancer clinical trials.
Purpose of the Study:
- To detail the evolution of economic analyses within the RTOG Outcomes Model.
- To demonstrate the application of economic evaluations to RTOG clinical trials for various cancers.
- To inform clinicians and policymakers about the economic value of new cancer treatments.
Main Methods:
- Evolution from average cost-utility analysis to sophisticated Monte Carlo simulation of Markov models.
- Incorporation of prospective economic analyses as an initial endpoint in clinical trials.
- Economic analyses performed on RTOG trials for non-small cell lung cancer, head and neck cancer, and prostate cancer.
Main Results:
- Concurrent chemotherapy and radiation for non-small cell lung cancer is economically acceptable when considering quality-adjusted survival.
- More aggressive radiation fractionation schedules for head and neck cancer are within acceptable economic recommendations.
- The addition of hormone therapy to radiation for prostate cancer is also found to be economically acceptable.
Conclusions:
- RTOG's economic analyses provide valuable insights into the cost-effectiveness of cancer treatments.
- The developed Outcomes Model comprehensively assesses the triad of clinical, humanistic, and economic endpoints.
- Economic evaluations inform decision-making regarding the adoption of new or improved cancer therapies.
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