Evidence map›Paper›PMID 34030646›Full record

ArticleBMC cancer2021

Initiation of Somatostatin analogues for neuroendocrine tumor patients: a cost-effectiveness analysis.

Sheila D Rustgi, Aaron Oh, Jeong Yun Yang, Dasol Kang, Edward Wolin, Chung Y Kong, Chin Hur, Michelle K Kim

Abstract read
In one paragraph

Article in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
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  5. Article
  6. Quality of Life and Cost Considerations: Y-90 Radioembolization.Seminars in interventional radiology · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sheila D RustgiHenry D. Janowitz Division of Gastroenterology, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1118, New York, NY, 10029-6574, USA.
Aaron OhColumbia University Irving Cancer Center, Columbia University Medical Center, New York, NY, USA.
Jeong Yun YangIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Dasol KangDepartment of Internal Medicine, Lincoln Medical Center, Bronx, NY, USA.
Edward WolinDivision of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Chung Y KongDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Chin HurColumbia University Irving Cancer Center, Columbia University Medical Center, New York, NY, USA.
Michelle K KimHenry D. Janowitz Division of Gastroenterology, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1118, New York, NY, 10029-6574, USA. michelle.kim@mountsinai.org.

Funding

Optimizing the Treatment of Pancreatic AdenocarcinomaR01CA212086 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI HUR, CHIN, KONG, CHUNG YIN · 2017 to 2021
$2.1M
American Cancer Society MRSG-14-014-01-CCENCI NIH HHS R01 CA212086NCI NIH HHS R01CA212086
6 · The paper itself

Abstract

BACKGROUND &

aimsGastroenteropancreatic neuroendocrine tumors (GEP-NETs) are heterogeneous neoplasms. Although some have a relatively benign and indolent natural history, others can be aggressive and ultimately fatal. Somatostatin analogues (SSAs) improve both quality of life and survival for these patients once they develop metastatic disease. However, these drugs are costly and their cost-effectiveness is not known.

methodsA decision-analytic model was developed and analyzed to compare two treatment strategies for patients with Stage IV GEP-NETs. The first strategy had all patients start SSA immediately while the second strategy waited, reserving SSA initiation until the patient showed signs of progression. Sensitivity analysis was performed to explore model parameter uncertainty.

resultsOur model of patients age 60 with metastatic GEP-NETs suggests empiric initiation of SSA led to an increase 0.62 unadjusted life-years and incremental increase in quality-adjusted life years (QALYs) of 0.44. The incremental costs were $388,966 per QALY and not cost-effective at a willingness-to-pay threshold of $100,000. Death was attributed to GEP-NETs for 94.1% of patients in the SSA arm vs. 94.9% of patients in the DELAY SSA arm. Sensitivity analysis found that the model was most sensitive to costs of SSAs. Using probabilistic sensitivity analysis, the SSA strategy was only cost-effective 1.4% of the time at a WTP threshold of $100,000 per QALY.

conclusionsOur modeling study finds it is not cost-effective to initiate SSAs at time of presentation for patients with metastatic GEP-NETs. Further clinical studies are needed to identify the optimal timing to initiate these drugs.

Indexed as

Drug CostsQuality of LifeComputer SimulationCost-Benefit AnalysisDecision MakingDisease ProgressionHumansIntestinal NeoplasmsMarkov ChainsModels, EconomicNeuroendocrine TumorsPancreatic NeoplasmsQuality-Adjusted Life YearsSomatostatinStomach NeoplasmsSomatostatinCarcinoidCost-effectiveness analysisNeuroendocrine tumorsPeptide receptor radionuclide therapySomatostatin analogues

Identifiers

PMID34030646
PMCPMC8146685

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.