Is SABR cost-effective in oligometastatic cancer? An economic analysis of SABR-COMET randomized trial
Abstract
The phase II randomized study SABR-COMET demonstrated that in cancer patients with 1-5 oligometastatic lesions, stereotactic ablative radiotherapy (SABR) was associated with an improvement in both progression-free survival and overall survival compared to standard of care (SoC). SABR, however, is associated with higher costs and treatment-related toxicity. The objective of this study was to assess the cost-effectiveness of SABR versus SoC in patients with oligometastatic disease.
A time-dependent Markov model with five health states was constructed from the Canadian health care system perspective. Utility values and transition probabilities were derived from the SABR-COMET trial. Costs were obtained from the published literature. A willingness-to-pay threshold of $100,000/quality adjusted life year (QALY) was used.
SABR was cost-effective in the base case, at an incremental cost-effectiveness ratio of $37,157/ QALY gained over a lifetime horizon, as compared to the SoC. Therefore, administering SABR is cost-effective for patients with 1-5 oligometastatic lesions compared to SoC.