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Real-world clinical outcomes and cost estimates of metastatic castration-resistant prostate cancer treatment: does sequencing of taxanes and androgen receptor-targeted agents matter?

Authors :
Pereira-Salgado A
Anton A
Franchini F
Mahar RK
Kwan EM
Wong S
Shapiro J
Weickhardt A
Azad AA
Spain L
Gunjur A
Torres J
Parente P
Parnis F
Goh J
Steer C
Brown S
Gibbs P
Tran B
IJzerman M
Source :
Expert review of pharmacoeconomics & outcomes research [Expert Rev Pharmacoecon Outcomes Res] 2023 Feb; Vol. 23 (2), pp. 231-239. Date of Electronic Publication: 2022 Dec 28.
Publication Year :
2023

Abstract

Introduction: Health economic outcomes of real-world treatment sequencing of androgen receptor-targeted agents (ARTA) and docetaxel (DOC) remain unclear.<br />Material and Methods: 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.<br />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.<br />Conclusion: ICERs show ARTA had improved clinical benefit compared to DOC but at higher cost. There were no significant cost differences between combined sequences.

Details

Language :
English
ISSN :
1744-8379
Volume :
23
Issue :
2
Database :
MEDLINE
Journal :
Expert review of pharmacoeconomics & outcomes research
Publication Type :
Academic Journal
Accession number :
36541133
Full Text :
https://doi.org/10.1080/14737167.2023.2161048