Economic evaluation of adjuvant chemotherapy for non-metastatic sarcoma using the real-world data from the French nationwide DEEPSARC study
Abstract
Objective: The efficacy of adjuvant chemotherapy (AC) in improving survival for patients with sarcoma is debated. We performed a cost-effectiveness analysis (CEA) comparing AC vs. no AC for non-metastatic sarcoma based on the nationwide retrospective study DEEPSARC. Methods: The CEA was carried out over a 1-, 3-, and five-year horizon, using data from the French NETSARC+ database linked to the French national health data system (SNDS).There was no age limit and no specific histological type selection in the reference case analysis. Costs (expressed in 2021 EUR) were provided by the SNDS from the French national health insurance perspective. Incremental cost effectiveness ratios (ICER) were expressed in cost per life-year gained (LYG). Propensity score analysis with 1:1 matching was undertaken. Sensitivity and subgroup analyses were performed. Results: Of the 33,548 patients from the French NETSARC+ database, 24,539 were linked to the SNDS. A total of 14,808 patients diagnosed between 2012 and 2017 were included in the reference case analysis with 2,784 patients after propensity score matching. Mean costs (SD) [95% CI] differences per patient between AC and no AC were €12,826 (36,758) [10,883-14,719], €15,706 (49,849) [13,330-18,383], and €16,841 (56,060) [13,590-19,657] at 1, 3, and 5 years, respectively. Mean overall survival differences per patient (in years) were 0.0066 (0.1685) [-0.0021 to 0.0157], -0.0728 (0.9336) [-0.1237 to -0.0229], and -0.1204 (1.3595) [-0.1926 to -0.0475] at 1, 3, and 5 years, respectively. ICER was €1,934,511 [-11,767,351-15,829,959] per LYG at 1 year. AC lagged behind at 3 and 5 years. Conclusions: In the reference case analysis, AC outperformed its use in terms of outcomes at 1 year, but a high level of willingness to pay would be required for AC to be cost-effective. At 3 and 5 years, AC was deemed to be not cost-effective for patients with non-metastatic sarcoma.
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BibTeX
@article{perrier2026economic,
title = {{Economic evaluation of adjuvant chemotherapy for non-metastatic sarcoma using the real-world data from the French nationwide DEEPSARC study}},
author = {Lionel Perrier and Magali Morelle and Sylvie Bonvalot and Daniel Orbach and Carmen Llacer-Moscardo and Anne Ducassou and Erwan Drézen and Claire Chemin-Airiau and Hugo Crochet and Françoise Ducimetière and Francois Gouin and André Happe and Noémie Huchet and François Le Loarer and Axel Lecesne and Simone Mathoulin-Pélissier and Pierre Méeus and Emmanuel Oger and Vincent Thevenet and Maud Toulmonde and Gualter Vaz and Marie Karanian and Carine Ngo and Gonzague de Pinieux and Anne Gomez-Mascard and Emmanuelle Bompas and Nicolas Macagno and Nelly Firmin and Nicolas Penel and Jean-Yves Blay},
journal = {Journal of Medical Economics},
year = {2026},
month = nov,
doi = {10.1080/13696998.2026.2689294},
url = {https://hal.science/hal-05851907v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Economic evaluation of adjuvant chemotherapy for non-metastatic sarcoma using the real-world data from the French nationwide DEEPSARC study
AU - Lionel Perrier
AU - Magali Morelle
AU - Sylvie Bonvalot
AU - Daniel Orbach
AU - Carmen Llacer-Moscardo
AU - Anne Ducassou
AU - Erwan Drézen
AU - Claire Chemin-Airiau
AU - Hugo Crochet
AU - Françoise Ducimetière
AU - Francois Gouin
AU - André Happe
AU - Noémie Huchet
AU - François Le Loarer
AU - Axel Lecesne
AU - Simone Mathoulin-Pélissier
AU - Pierre Méeus
AU - Emmanuel Oger
AU - Vincent Thevenet
AU - Maud Toulmonde
AU - Gualter Vaz
AU - Marie Karanian
AU - Carine Ngo
AU - Gonzague de Pinieux
AU - Anne Gomez-Mascard
AU - Emmanuelle Bompas
AU - Nicolas Macagno
AU - Nelly Firmin
AU - Nicolas Penel
AU - Jean-Yves Blay
PY - 2026
DA - 2026/11/04
JO - Journal of Medical Economics
DO - 10.1080/13696998.2026.2689294
UR - https://hal.science/hal-05851907v1
AB - Objective: The efficacy of adjuvant chemotherapy (AC) in improving survival for patients with sarcoma is debated. We performed a cost-effectiveness analysis (CEA) comparing AC vs. no AC for non-metastatic sarcoma based on the nationwide retrospective study DEEPSARC. Methods: The CEA was carried out over a 1-, 3-, and five-year horizon, using data from the French NETSARC+ database linked to the French national health data system (SNDS).There was no age limit and no specific histological type selection in the reference case analysis. Costs (expressed in 2021 EUR) were provided by the SNDS from the French national health insurance perspective. Incremental cost effectiveness ratios (ICER) were expressed in cost per life-year gained (LYG). Propensity score analysis with 1:1 matching was undertaken. Sensitivity and subgroup analyses were performed. Results: Of the 33,548 patients from the French NETSARC+ database, 24,539 were linked to the SNDS. A total of 14,808 patients diagnosed between 2012 and 2017 were included in the reference case analysis with 2,784 patients after propensity score matching. Mean costs (SD) [95% CI] differences per patient between AC and no AC were €12,826 (36,758) [10,883-14,719], €15,706 (49,849) [13,330-18,383], and €16,841 (56,060) [13,590-19,657] at 1, 3, and 5 years, respectively. Mean overall survival differences per patient (in years) were 0.0066 (0.1685) [-0.0021 to 0.0157], -0.0728 (0.9336) [-0.1237 to -0.0229], and -0.1204 (1.3595) [-0.1926 to -0.0475] at 1, 3, and 5 years, respectively. ICER was €1,934,511 [-11,767,351-15,829,959] per LYG at 1 year. AC lagged behind at 3 and 5 years. Conclusions: In the reference case analysis, AC outperformed its use in terms of outcomes at 1 year, but a high level of willingness to pay would be required for AC to be cost-effective. At 3 and 5 years, AC was deemed to be not cost-effective for patients with non-metastatic sarcoma.
SN - 1369-6998
SN - 1941-837X
ER -