Dutch Economic Value of Radium-223 in Metastatic Castration-Resistant Prostate Cancer
BACKGROUND: The treatment of metastatic castration-resistant prostate cancer has changed with the introduction of radium-223, cabazitaxel, abiraterone and enzalutamide. To assess value for money, their cost effectiveness in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel from the Dutch societal perspective was investigated. METHODS: A cost-effectiveness analysis was conducted using efficacy, symptomatic skeletal-related event and safety data obtained from indirect treatment comparisons. Missing skeletal-related event data for cabazitaxel were con... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2018 |
Reihe/Periodikum: | Peters , ML , De Meijer , C , Wyndaele , D , Noordzij , W , Leliveld , A M , van den Bosch , J , Van den Berg , PH , Baka , A & Gaultney , J 2018 , ' Dutch Economic Value of Radium-223 in Metastatic Castration-Resistant Prostate Cancer ' , Applied Health Economics and Health Policy , vol. 16 , no. 1 , pp. 133-143 . https://doi.org/10.1007/s40258-017-0350-x |
Schlagwörter: | COST-EFFECTIVENESS ANALYSIS / QUALITY-OF-LIFE / ABIRATERONE ACETATE / BONE METASTASES / DOCETAXEL TREATMENT / RANDOMIZED-TRIAL / UTILITY ANALYSIS / DOUBLE-BLIND / ENZALUTAMIDE / CHEMOTHERAPY |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-28619935 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://hdl.handle.net/11370/b3b78a6a-cdc7-468d-ae1d-599e53fa6dac |
BACKGROUND: The treatment of metastatic castration-resistant prostate cancer has changed with the introduction of radium-223, cabazitaxel, abiraterone and enzalutamide. To assess value for money, their cost effectiveness in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel from the Dutch societal perspective was investigated. METHODS: A cost-effectiveness analysis was conducted using efficacy, symptomatic skeletal-related event and safety data obtained from indirect treatment comparisons. Missing skeletal-related event data for cabazitaxel were conservatively assumed to be identical to radium-223. A Markov model combined these clinical inputs with Dutch-specific resource use and costs for metastatic castration-resistant prostate cancer treatment from a societal perspective. Total quality-adjusted life-years and costs in 2017 euros were calculated over a 5-year (lifetime) time horizon. RESULTS: Radium-223 resulted in €6092 and €4465 lower costs and 0.02 and 0.01 higher quality-adjusted life-years compared with abiraterone and cabazitaxel, respectively, demonstrating dominance of radium-223. Sensitivity analyses reveal a 64% (54%) chance of radium-223 being cost effective compared with abiraterone (cabazitaxel) at the informal €80,000 willingness-to-pay threshold. Compared with enzalutamide, radium-223 resulted in slightly lower quality-adjusted life-years (-0.06) and €7390 lower costs, revealing a 61% chance of radium-223 being cost effective compared with enzalutamide. The lower costs of radium-223 compared with abiraterone and enzalutamide are driven by lower drug costs and prevention of expensive skeletal-related events. Compared with cabazitaxel, the lower costs of radium-223 are driven by lower costs of the drug, administration and adverse events. CONCLUSION: Radium-223 may be a less costly treatment strategy offering similar gains in health benefits compared with abiraterone, cabazitaxel and enzalutamide in patients with metastatic castration-resistant prostate ...