Evidence map›Paper›PMID 35653395›Full record

Trial reportPloS one2022

Cost-utility analysis of adding abiraterone acetate plus prednisone/prednisolone to long-term hormone therapy in newly diagnosed advanced prostate cancer in England: Lifetime decision model based on STAMPEDE trial data.

Caroline S Clarke, Rachael M Hunter, Andrea Gabrio, Christopher D Brawley, Fiona C Ingleby, David P Dearnaley, David Matheson, Gerhardt Attard, Hannah L Rush, Rob J Jones and 12 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% of its field
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
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

22 authors at 16 institutions in 3 countries.

Caroline S ClarkeResearch Department of Primary Care and Population Health, University College London, London, United Kingdom.ORCID 0000-0002-4676-1257
Rachael M HunterResearch Department of Primary Care and Population Health, University College London, London, United Kingdom.
Andrea GabrioDepartment of Methodology and Statistics, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
Christopher D BrawleyMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.ORCID 0000-0003-3641-278X
Fiona C InglebyMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.
David P DearnaleyInstitute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom.
David MathesonPatient Representative, University of Wolverhampton, Wolverhampton, United Kingdom.ORCID 0000-0002-3695-3167
Gerhardt AttardUniversity College London Cancer Institute, London, United Kingdom.
Hannah L RushMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.ORCID 0000-0001-9550-8808
Rob J JonesBeatson West of Scotland Cancer Centre, Glasgow, United Kingdom.ORCID 0000-0002-2904-6980
William CrossDepartment of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Chris ParkerRoyal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom.
J Martin RussellBeatson West of Scotland Cancer Centre, Glasgow, United Kingdom.ORCID 0000-0003-4594-4155
Robin MillmanPatient Representative, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.
Silke GillessenDivision of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
Zafar MalikClatterbridge Cancer Centre NHS Foundation Trust, Birkenhead, United Kingdom.
Jason F LesterSouth West Wales Cancer Centre, Singleton Hospital, Swansea, United Kingdom.
James WylieChristie NHS Foundation Trust, Manchester, United Kingdom.
Noel W ClarkeChristie NHS Foundation Trust, Manchester, United Kingdom.
Mahesh K B ParmarMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.ORCID 0000-0003-0166-1700
Matthew R SydesMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.ORCID 0000-0002-9323-1371
Nicholas D JamesMRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom.ORCID 0000-0002-7314-8204
MRC Clinical Trials Unit at UCL · GBBeatson West of Scotland Cancer Centre · GBRoyal Marsden NHS Foundation Trust · GBUniversity College London · GBClatterbridge Cancer Centre NHS Foundation Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBInstitute of Cancer Research · GBLeeds Teaching Hospitals NHS Trust · GBLondon Cancer · GBLondon School of Hygiene & Tropical Medicine · GBMaastricht University · NLSalford Royal Hospital · GBSingleton Hospital · GBThe Christie NHS Foundation Trust · GBUniversity of Manchester · GBUniversity of Wolverhampton · GB

Funding

Cancer Research UK 12518Cancer Research UK 3804Cancer Research UK CRUK/06/019Cancer Research UK CRUK_A12459Medical Research Council MC_UU_00004/01Medical Research Council MC_UU_12023/25Medical Research Council MRC_MC_UU_12023/25
6 · The paper itself

Abstract

Adding abiraterone acetate (AA) plus prednisolone (P) to standard of care (SOC) improves survival in newly diagnosed advanced prostate cancer (PC) patients starting hormone therapy. Our objective was to determine the value for money to the English National Health Service (NHS) of adding AAP to SOC. We used a decision analytic model to evaluate cost-effectiveness of providing AAP in the English NHS. Between 2011-2014, the STAMPEDE trial recruited 1917 men with high-risk localised, locally advanced, recurrent or metastatic PC starting first-line androgen-deprivation therapy (ADT), and they were randomised to receive SOC plus AAP, or SOC alone. Lifetime costs and quality-adjusted life-years (QALYs) were estimated using STAMPEDE trial data supplemented with literature data where necessary, adjusting for baseline patient and disease characteristics. British National Formulary (BNF) prices (£98/day) were applied for AAP. Costs and outcomes were discounted at 3.5%/year. AAP was not cost-effective. The incremental cost-effectiveness ratio (ICER) was £149,748/QALY gained in the non-metastatic (M0) subgroup, with 2.4% probability of being cost-effective at NICE's £30,000/QALY threshold; and the metastatic (M1) subgroup had an ICER of £47,503/QALY gained, with 12.0% probability of being cost-effective. Scenario analysis suggested AAP could be cost-effective in M1 patients if priced below £62/day, or below £28/day in the M0 subgroup. AAP could dominate SOC in the M0 subgroup with price below £11/day. AAP is effective for non-metastatic and metastatic disease but is not cost-effective when using the BNF price. AAP currently only has UK approval for use in a subset of M1 patients. The actual price currently paid by the English NHS for abiraterone acetate is unknown. Broadening AAP's indication and having a daily cost below the thresholds described above is recommended, given AAP improves survival in both subgroups and its cost-saving potential in M0 subgroup.

Indexed as

Abiraterone AcetateProstatic NeoplasmsAcetatesAndrogen AntagonistsCost-Benefit AnalysisHormonesHumansMalePrednisolonePrednisoneState MedicineAbiraterone AcetateAcetatesAndrogen AntagonistsHormonesPrednisolonePrednisone

Identifiers

PMID35653395
PMCPMC9162346
OpenAlexW4281851622

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.