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 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.

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