Quality of life and cost-effectiveness of interferon-alpha in malignant melanoma: results from randomised trial.
A definitive conclusion regarding the value of low-dose extended duration adjuvant interferon-alpha therapy in the treatment of malignant melanoma is only possible once data on health-related quality of life (HRQoL) and costs have been considered. This trial randomised 674 patients to interferon alpha-2a (3 megaunits three times per week for 2 years or until recurrence) or placebo. Health-related quality of life (QoL) was to be assessed up to 60 months using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. Data for the economic analysis, including cost information and the EQ-5D were also collected. Patients in the observation (OBS) group had significantly better mean follow-up quality of on five dimensions of the EORTC QLQ-C30 functional scales: role functioning (P = 0.033), emotional functioning (P = 0.003), cognitive functioning (P = 0.001), social functioning (P = 0.003) and global health status (P = 0.001). Patients in the OBS group had significantly better mean follow-up symptom scores on seven dimensions of the EORTC QLQ-C30 V1 symptom scales. Economic data showed that costs were 3066 pounds higher in the interferon group and produces an incremental cost per quality-adjusted life year of 41,432 pounds at 5 years. The results show that interferon has significant effects on QoL and symptomatology and is unlikely to be cost-effective in this patient group in the UK.
Dixon
S
S
Health Economics and Decision Science, and Trent Research and Development Support Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. s.dixon@shef.ac.uk
Walters
S J
SJ
Turner
L
L
Hancock
B W
BW
D000328:Adult; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000191:economics; D008875:Middle Aged; D010919:Placebos; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000191:economics; D016019:Survival Analysis
D000970:Antineoplastic Agents; D016898:Interferon-alpha; D010919:Placebos