scholarly journals Results Of A Dutch Cost-Effectiveness Model Of Radium-223 In Comparison To Cabazitaxel, Abiraterone, And Enzalutamide In Patients With Metastatic Castration Resistant Prostate Cancer Previously Treated With Docetaxel

2015 ◽  
Vol 18 (7) ◽  
pp. A459 ◽  
Author(s):  
J Gaultney ◽  
A Baka ◽  
A Leliveld-Kors ◽  
W Noordzij ◽  
D Wyndaele ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Effectiveness Model ◽  
Radium 223 ◽  
Previously Treated

scholarly journals Cost-effectiveness analysis of cabazitaxel for metastatic castration resistant prostate cancer after docetaxel and androgen-signaling-targeted inhibitor resistance

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng-Fei Zhang ◽  
Dan Xie ◽  
Qiu Li
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Sensitivity Analyses ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Effectiveness Analysis ◽  
Previously Treated ◽  
Markov Decision Model ◽  
The Cost

Abstract Background The aim of our study was to evaluate the cost-effectiveness of cabazitaxel versus abiraterone or enzalutamide in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel who had progression within 12 months while receiving an alternative inhibitor (abiraterone or enzalutamide) from a US payer’s perspective. Methods To conduct the cost-effectiveness analysis, a Markov decision model was established. Three health states (progression-free survival (PFS), progressive disease (PD) and death) were included, and the incremental cost-effectiveness ratio (ICER) was regarded as the primary endpoint. The willingness-to-pay (WTP) threshold was set at $100,000.00/quality-adjusted life year (QALY), and discounted rates were set at 3% annually. Efficacy data were derived from the CARD trial and Weibull distribution curves were modeled to fit the survival curves. The robustness of the analysis was tested with a series of one-way sensitivity analyses and probabilistic sensitivity analyses. Results Overall, the incremental effectiveness and cost of cabazitaxel versus androgen-signaling-targeted inhibitors (ASTIs) were 0.16 QALYs and $49,487.03, respectively, which yielded an ICER of $309,293.94/QALY. Our model was mostly sensitive to the duration of PFS in the cabazitaxel group, cost of cabazitaxel and utility of the PFS state. At a WTP threshold of $100,000.00/QALY, cabazitaxel was the dominant strategy in 0% of the simulations. Conclusions Cabazitaxel is unlikely to be a cost-effective treatment option compared with ASTIs in patients with mCRPC previously treated with docetaxel who had progression within 12 months while receiving ASTIs.

scholarly journals Health Economics and Radium-223 (Xofigo®) in the Treatment of Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Case History and a Systematic Review of the Literature

2015 ◽  
Vol 8 (4) ◽  
pp. 1 ◽  
Author(s):  
Jan Norum ◽  
Erik R. Traasdahl ◽  
Arpad Totth ◽  
Carsten Nieder ◽  
Jan Abel Olsen
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Health Economics ◽  
Randomized Clinical Trials ◽  
Cost Effective ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Radium 223 ◽  
Life Years ◽  
Google Search

<p><strong>OBJECTIVES: </strong>Prostate cancer (PC) is the most common cancer in Western countries. Recent advances in the treatment of metastatic castration resistant prostate cancer (mCRPC) have caused significant pressure on health care budgets. We aimed to exemplify this dilemma presenting an example, radium-223 (Xofigo®), and review the literature.</p> <p><strong>METHODS:</strong> A 74-year-old man diagnosed with mCRPC was referred to our department in October 2014 for radium-223 therapy. We faced the following dilemma: is radium-223 standard therapy? Is it cost-effective? Medline was searched employing the following search criteria: “radium-223”, “alpharadin”, “Xofigo” and “prostate”. Exclusion and inclusion criteria were applied. Guidelines and cost-effectiveness analyses were focused. We also searched the websites of ASCO, ESMO and ISPOR. The web was searched, using Yahoo and Google search engines, for Health Technology Assessments (HTAs).</p> <p><strong>RESULTS: </strong>181 publications were identified in the Medline database. Only four studies included the word “cost”, three “economics” and none “budget” in heading or abstract. None of the publications were thorough of cost analysis (cost-effectiveness, cost-utility, cost-minimizing or cost-of-illness analysis). Six HTAs and eight national guidelines were identified. The cost per quality adjusted life years was indicated €80.000-94,000. HTAs concluded reimbursement being not recommendable or no ultimate statement could be made. One pointed towards a limited use with caution.</p> <p><strong>CONCLUSION:</strong> Guidelines were based on data from randomized clinical trials (RCTs). Health economics was not considered when guidelines were made. Most HTAs concluded this therapy not cost-effective or there was insufficient data for final conclusions. Licensing and reimbursement processes should be run simultaneously.</p>

scholarly journals Cost-effectiveness Analysis of Radium-223 Dichloride in Metastatic Castration-Resistant Prostate Cancer Patients Without Previous Chemotherapy Treatment in Spain

10.36469/9777 ◽  
2018 ◽  
Vol 6 (1) ◽  
pp. 1-14
Author(s):  
Eva Tirado ◽  
Daniel Callejo Velasco ◽  
Marta Rubio Cabezas ◽  
Cristina Moretones Agut ◽  
Meritxell Granell Villalón
Keyword(s):  
Prostate Cancer ◽  
Cost Effectiveness ◽  
Health Outcomes ◽  
Cost Effectiveness Analysis ◽  
Castration Resistant Prostate Cancer ◽  
System Perspective ◽  
Castration Resistant ◽  
Effectiveness Analysis ◽  
Radium 223 ◽  
Docetaxel Treatment

Purpose: To perform a cost-effectiveness analysis of radium-223 plus Best Supportive Care (BSC) compared to BSC in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) and without previous docetaxel treatment in Spain. Design and methods: A Markov model was developed to compare radium-223 versus BSC and to accrue the health outcomes and costs of a simulated cohort of mCRPC patients. Quality-adjusted life year (QALY) and life year (LY) were selected as health outcomes to measure the effectiveness of treatment alternatives. Main health resource use and efficacy inputs were obtained from a randomized controlled trial comparing radium-223 versus placebo. Unit costs were retrieved from Spanish databases and published sources. One-way and probabilistic sensitivity analyses were carried out to assess uncertainty. Results: Total costs and QALYs were €65 067 and 1.12 QALYs for radium-223 and €55 437 and 0.77 QALYs for BSC. Therefore, incremental costs per QALY were €27 606. The sensitivity analysis showed that with a willingness-to-pay threshold of €30 000 per QALY, radium-223 would have a probability of 48% of being cost-effective compared to BSC. Conclusions: Although results must be assessed with caution, from the Spanish National Health System perspective and based on the results of the present analysis, radium-223 could be a suitable option of health resources’ utilization for end of life mCRPC without previous docetaxel treatment, subject to a moderate level of uncertainty.

scholarly journals Early alkaline phosphatase dynamics as biomarker of survival in metastatic castration-resistant prostate cancer patients treated with radium-223

2021 ◽  
Author(s):  
Maarten J. van der Doelen ◽  
Agnes Stockhaus ◽  
Yuanjun Ma ◽  
Niven Mehra ◽  
Jeffrey Yachnin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Alkaline Phosphatase ◽  
Confidence Interval ◽  
Surrogate Marker ◽  
Response Monitoring ◽  
Castration Resistant Prostate Cancer ◽  
Related Event ◽  
Castration Resistant ◽  
Radium 223 ◽  
Skeletal Related Event

Abstract Purpose Radium-223 is a life-prolonging therapy for castration-resistant prostate cancer (CRPC) patients with symptomatic bone metastases. However, validated biomarkers for response monitoring are lacking. The study aim was to investigate whether early alkaline phosphatase (ALP) dynamics after the first radium-223 injection can act as surrogate marker for overall survival (OS). Methods This retrospective multicenter study included consecutive CRPC patients treated with radium-223. Patients were divided into four subgroups based on baseline ALP level (normal/elevated) and early ALP response, defined as ≥10% ALP decrease after the first radium-223 injection. Primary endpoint was OS among the subgroups. Secondary endpoints included time to first skeletal-related event, time to ALP progression, and treatment completion rate. Results A total of 180 patients were included for analysis. Median OS was 13.5 months (95% confidence interval 11.5–15.5). Patients with elevated baseline ALP without ALP response after the first injection had significantly worse OS when compared to all other patients (median OS 7.9 months versus 15.7 months, hazard ratio 2.56, 95% confidence interval 1.73–3.80, P < 0.001). Multivariate analysis demonstrated that elevated baseline ALP without ALP response after the first injection, the number of prior systemic therapies, baseline LDH level, and baseline ECOG performance status were prognostic factors of OS. Patients with elevated baseline ALP without ALP response after the first injection had significantly shorter times to ALP progression and first skeletal-related event, and more frequently discontinued radium-223 therapy when compared to other patients. Conclusion Early treatment–induced changes in ALP after one radium-223 injection were associated with OS in metastatic CRPC patients.

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