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dc.contributor.authorTran, Anh Dam
dc.contributor.authorHong, Angela M.
dc.contributor.authorNguyen, Mai T. H.
dc.contributor.authorFogarty, Gerald
dc.contributor.authorSteel, Victoria
dc.contributor.authorPaton, Elizabeth
dc.contributor.authorMorton, Rachael L.
dc.date.accessioned2023-03-21T02:05:47Z
dc.date.available2023-03-21T02:05:47Z
dc.date.issued2022en_AU
dc.identifier.urihttps://hdl.handle.net/2123/30255
dc.description.abstractPurpose We aimed to compare Australian health system costs at 12 months for adjuvant whole-brain radiotherapy (WBRT) treatment after stereotactic radiosurgery (SRS) and/or surgery versus observation among adults with one to three melanoma brain metastases. We hypothesized that treatment with adjuvant WBRT and subsequent healthcare would be more expensive than SRS/surgery alone. Methods The analysis was conducted alongside a multicentre, randomized phase III trial. A bespoke cost questionnaire was used to measure healthcare use, including hospitalizations, specialist and primary care visits, imaging, and medicines over 12 months. Mean per-patient costs were calculated based on the quantity of resources used and unit costs, reported in Australian dollars ($AU), year 2018 values. Skewness of cost data was determined using normality tests and censor-adjusted costs reported using the Kaplan–Meier sample average method. The analysis of diference in mean costs at each 2-month time point and at 12 months was performed and checked using Kruskal–Wallis, generalized linear models with gamma distribution and log link, modifed Park test, ordinary least squares, and non-parametric bootstrapping. Results In total, 89 patients with similar characteristics at baseline were included in the cost analysis (n = 43 WBRT; n = 46 observation). Hospitalization cost was the main cost, ranging from 63 to 89% of total healthcare costs. The unadjusted 12-monthly cost for WBRT was $AU71,138 ± standard deviation 41,475 and for observation $AU69,848 ± 33,233; p = 0.7426. The censor-adjusted 12-monthly cost for WBRT was $AU90,277 ± 36,274 and $AU82,080 ± 34,411 for observation. There was no signifcant diference in 2-monthly costs between groups (p > 0.30 for all models). Conclusions Most costs were related to inpatient hospitalizations associated with disease recurrence. Adding WBRT after local SRS/surgery for patients with one to three melanoma brain metastases did not signifcantly increase health system costs during the frst 12 months. Trial Registration ACTRN12607000512426, prospectively registered 14 September 2007en_AU
dc.language.isoenen_AU
dc.publisherPharmacoEconomics - Openen_AU
dc.rightsCreative Commons Attribution-NonCommercial 4.0en_AU
dc.subjectCost analysisen_AU
dc.subjectWhole-brain radiotherapyen_AU
dc.subjectstereotactic radiosurgeryen_AU
dc.subjectMelanomaen_AU
dc.subjectmetastasesen_AU
dc.subjectRandomized Trialen_AU
dc.titleCost Analysis of Adjuvant Whole‑Brain Radiotherapy Treatment Versus No Whole‑Brain Radiotherapy After Stereotactic Radiosurgery and/or Surgery Among Adults with One to Three Melanoma Brain Metastases: Results from a Randomized Trialen_AU
dc.typeArticleen_AU
dc.identifier.doihttps://doi.org/10.1007/s41669-022-00332-8
dc.type.pubtypePublisher's versionen_AU
usyd.facultyFaculty of Medicine and Healthen_AU
usyd.departmentNHMRC Clinical Trials Centreen_AU
workflow.metadata.onlyNoen_AU


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