Real-world clinical outcomes and cost estimates of metastatic castration-resistant prostate cancer treatment: does sequencing of taxanes and androgen receptor-targeted agents matter?
Expert Rev Pharmacoecon Outcomes Res
; 23(2): 231-239, 2023 Feb.
Article
in En
| MEDLINE
| ID: mdl-36541133
ABSTRACT
INTRODUCTION:
Health economic outcomes of real-world treatment sequencing of androgen receptor-targeted agents (ARTA) and docetaxel (DOC) remain unclear. MATERIAL ANDMETHODS:
Data from the electronic Castration-resistant Prostate cancer Australian Database (ePAD) were analyzed including median overall survival (mOS) and median time-to-treatment failure (mTTF). Mean total costs (mTC) and incremental cost-effectiveness ratios (ICER) of treatment sequences were estimated using the average sample method and Zhao and Tian estimator.RESULTS:
Of 752 men, 441 received ARTA, 194 DOC, and 175 both sequentially. Of participants treated with both, first-line DOC followed by ARTA was the more common sequence (n = 125, 71%). mOS for first-line ARTA was 8.38 years (95% CI 3.48, not-estimated) vs. 3.29 years (95% CI 2.92, 4.02) for DOC. mTTF was 15.7 months (95% CI 14.2, 23.7) for the ARTA-DOC sequence and 18.2 months (95% CI 16.2, 23.2) for DOC-ARTA. In first-line, ARTA cost an additional $13,244 per mTTF month compared to DOC. In second-line, ARTA cost $6726 per mTTF month. The DOC-ARTA sequence saved $2139 per mTTF compared to ARTA-DOC, though not statistically significant.CONCLUSION:
ICERs show ARTA had improved clinical benefit compared to DOC but at higher cost. There were no significant cost differences between combined sequences.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatic Neoplasms, Castration-Resistant
/
Antineoplastic Agents
Type of study:
Health_economic_evaluation
Limits:
Humans
/
Male
Country/Region as subject:
Oceania
Language:
En
Journal:
Expert Rev Pharmacoecon Outcomes Res
Journal subject:
FARMACOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Australia