Cost-effectiveness analysis of enzalutamide for patients with chemotherapy-naïve metastatic castration-resistant prostate cancer in Japan.
Jpn J Clin Oncol
; 51(8): 1319-1329, 2021 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-34037235
ABSTRACT
BACKGROUND:
We aimed to evaluate cost-effectiveness of enzalutamide in chemotherapy-naïve metastatic castration-resistant prostate cancer patients in Japan.METHODS:
A Markov model was developed to capture time spent by patients in various health states stable, progression and death. Abiraterone acetate and docetaxel were set as active comparators. Clinical outcomes were obtained from the PREVAIL, COU-AA-302 and TAX327 trials. Treatment sequence, concomitant drugs and therapies for adverse events were estimated from responses to a survey by 14 Japanese prostate cancer experts. The analytic perspective was public healthcare payer, with a 10-year time horizon. The incremental cost-effectiveness ratio was estimated from quality-adjusted life-years and Japanese public healthcare costs. Probabilistic sensitivity analysis was performed to assess the robustness of the findings.RESULTS:
According to the survey, the most common treatment sequences were (i) enzalutamide â docetaxel â cabazitaxel (enzalutamide-first sequencing), (ii) abiraterone â enzalutamide â docetaxel (abiraterone-first sequencing) and (iii) docetaxelâ enzalutamide â cabazitaxel (docetaxel-first sequencing). In the base-case analysis, enzalutamide-first sequencing saved 1.74 million Japanese Yen versus abiraterone-first sequencing, with a 0.129 quality-adjusted life-year gain (dominant). Enzalutamide-first sequencing had a cost increase of 4.44 million Japanese Yen over docetaxel-first sequencing, with a 0.371 quality-adjusted life-years gain. The incremental cost-effectiveness ratio of enzalutamide-first sequencing versus docetaxel-first sequencing was estimated as 11.94 million Japanese Yen/quality-adjusted life-years. Probabilistic sensitivity analyses demonstrated that, compared with abiraterone-first sequencing, enzalutamide-first sequencing had an 87.4% probability of being dominant.CONCLUSIONS:
Results modeled herein suggest that the enzalutamide-first sequencing is more cost-effective than the abiraterone-first sequencing, but less cost-effective than docetaxel-first sequencing for chemotherapy-naïve patients with metastatic castration-resistant prostate cancer.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Feniltioidantoína
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Benzamidas
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Neoplasias de Próstata Resistentes à Castração
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Nitrilas
Tipo de estudo:
Health_economic_evaluation
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Prognostic_studies
Limite:
Aged
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Humans
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Male
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article