Pennies on the dollar.
SABR-COMET demonstrated improved survival outcomes with consolidative stereotactic body radiation (SBRT) for oligometastatic disease in a phase 2 setting. What more could we ask for? With CMS reimbursement changes looming, this unplanned secondary analysis saw fit to scrutinize the cost effectiveness of this treatment paradigm. Markov models using established costs for SBRT divided by the probabilities of outcomes per the trial demonstrated that one additional quality-adjusted life year (QALY) came at the expense of $28,906 healthcare dollars and $38,783 societal dollars. In other words, it easily passes an a priori threshold of “cost effective” set at $100,000 per QALY. TBL: In almost any scenario, consolidative SBRT for oligometastatic disease per the SABR-COMET trial is cost-effective. | Kumar, Int J Radiat Oncol Biol Phys 2020