Economic Evaluation of Adjuvant Chemotherapy for Soft Tissue Sarcoma Using Linked NETSARC+ (French Registry) and SNDS (French National Health Data System) Real World Data: The Deepsarc Study
Author(s)
Lionel Perrier, PhD1, Magali Morelle, MSc1, Sylvie Bonvalot, MD2, Claire Chemin, MSc1, Hugo Crochet, Ing1, Anne Ducassou, MD3, Françoise Ducimetière, PhD1, François Gouin, MD, PhD1, André Happe, PhD4, Noémie Huchet, PhD5, François Le Loarer, MD, PhD5, Axel Le Cesne, MD6, Carmen Llacer, MD7, Simone Mathoulin-Pelissier, MD, PhD8, Pierre Méeus, MD1, Daniel Orbach, MD2, Vincent Thévenet, MD5, Maud Toulmonde, MD5, Gualter Vaz, MD1, Nicolas Penel, MD, PhD9, Jean-Yves BLAY, MD, PhD1;
1Cancer Centre Leon Berard, Lyon, France, 2Institut Curie, Paris, France, 3IUCT-Oncopole, Toulouse, France, 4Univ Rennes, EA 7449 REPERES, Rennes, France, 5Institut Bergonié Comprehensive Cancer Center, Bordeaux, France, 6Gustave Roussy Comprehensive Cancer Center, Villejuif, France, 7Montpellier Cancer Institute, Montpellier, France, 8Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, Bordeaux, France, 9Centre Oscar Lambret, Lille, France
1Cancer Centre Leon Berard, Lyon, France, 2Institut Curie, Paris, France, 3IUCT-Oncopole, Toulouse, France, 4Univ Rennes, EA 7449 REPERES, Rennes, France, 5Institut Bergonié Comprehensive Cancer Center, Bordeaux, France, 6Gustave Roussy Comprehensive Cancer Center, Villejuif, France, 7Montpellier Cancer Institute, Montpellier, France, 8Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, Bordeaux, France, 9Centre Oscar Lambret, Lille, France
Presentation Documents
OBJECTIVES: The efficacy of adjuvant chemotherapy (CT) to reduce the risk of relapse and improve survival for patients with high grade localized resected soft-tissue sarcoma (STS) is debated in clinical practice guidelines. We conducted an economic evaluation based on real-world data, i.e. a cost description of STS and a cost-effectiveness analysis (CEA) comparing adjuvant CT vs. no adjuvant CT.
METHODS: Costs were assessed from the French health care system perspective with a 1-, 3-, and 5-years horizon using data from the French database NETSARC+ linked to the SNDS1. Costs were discounted at 2.5% rate. Incremental cost-effectiveness ratios (ICERs) in cost per life year gained (LYG) were calculated. Propensity score analysis matching (1:1) was undertaken in an effort to minimize potential bias due to absence of randomization. Uncertainty around ICERs was captured by bootstrap.
RESULTS: Of the 33,548 patients from NETSARC+, 24,539 were linked to the SNDS, achieving a correspondence of 73.1 %. Overall, 8,331 adult patients diagnosed with STS between 2012 and 2017 were included. Mean total costs (SD) per patient were €21,643 (21,063), €31,847 (29,954), €35,763 (33,687) at 1, 3, and 5 years respectively. After propensity score matching (N=778 patients), mean total costs (SD) differences per patient between adjuvant CT and no adjuvant CT groups were €12,907 (26,946), €13,149 (47,694), and €13,946 (53,602) at 1, 3, and 5 years respectively. Mean overall survival differences (SD) per patient (in years) between CT and no CT were -0.0122 (0.1744), -0.2154 (1.0791), -0.3238 (1.5466) at 1, 3, and 5 years respectively.
CONCLUSIONS: As few studies have addressed the costs of care for patients with STS, this economic evaluation adds new information to the existing literature. However, adjuvant CT was deemed to be not cost-effective compared with no adjuvant CT for patients with unselected STS. 1Thevenet et al. J Epidemiol Popul Health 2024. https://doi.org/10.1016/j.jeph.2024.202450
METHODS: Costs were assessed from the French health care system perspective with a 1-, 3-, and 5-years horizon using data from the French database NETSARC+ linked to the SNDS1. Costs were discounted at 2.5% rate. Incremental cost-effectiveness ratios (ICERs) in cost per life year gained (LYG) were calculated. Propensity score analysis matching (1:1) was undertaken in an effort to minimize potential bias due to absence of randomization. Uncertainty around ICERs was captured by bootstrap.
RESULTS: Of the 33,548 patients from NETSARC+, 24,539 were linked to the SNDS, achieving a correspondence of 73.1 %. Overall, 8,331 adult patients diagnosed with STS between 2012 and 2017 were included. Mean total costs (SD) per patient were €21,643 (21,063), €31,847 (29,954), €35,763 (33,687) at 1, 3, and 5 years respectively. After propensity score matching (N=778 patients), mean total costs (SD) differences per patient between adjuvant CT and no adjuvant CT groups were €12,907 (26,946), €13,149 (47,694), and €13,946 (53,602) at 1, 3, and 5 years respectively. Mean overall survival differences (SD) per patient (in years) between CT and no CT were -0.0122 (0.1744), -0.2154 (1.0791), -0.3238 (1.5466) at 1, 3, and 5 years respectively.
CONCLUSIONS: As few studies have addressed the costs of care for patients with STS, this economic evaluation adds new information to the existing literature. However, adjuvant CT was deemed to be not cost-effective compared with no adjuvant CT for patients with unselected STS. 1Thevenet et al. J Epidemiol Popul Health 2024. https://doi.org/10.1016/j.jeph.2024.202450
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE275
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology