Abstract
270 Background: Abiraterone acetate (AA) and enzalutamide (ENZ) are two new agents indicated for the treatment of patients with mCRPC. Presently, there is a high level of interest in understanding the relative clinical and economic value of these therapies. The objective of this study was to determine the comparative effectiveness and cost-effectiveness of AA vs. ENZ. Methods: The PICO (population, intervention, comparison, and outcomes) construct was used to assess the comparability of Study COU-AA-301 for AA and the AFFIRM trial for ENZ, and an ITC was conducted using the Bucher method and Bayesian statistics. A survival-based Markov cohort model with three health states (progression-free, progressed, and death) was developed to project cost-effectiveness over a life time horizon. Since only the US price of ENZ was publicly available at the time of analysis, US drug acquisition costs were used. Average wholesale prices for 30-day supplies of AA and ENZ were $7,674 and $8,940, respectively. One-way sensitivity analyses were performed for all probability, utility, and cost values incorporated into the model. Results: The ITC result on overall survival (OS) was HR = 0.95 (95% CI: 0.71-1.26) for AA vs. ENZ on the risk of mortality, after accounting for important differences in comparators and background treatments. In the base case of the economic analysis, AA was found to provide a substantial cost savings of $13,322 per patient vs. ENZ, primarily due to higher acquisition costs. Quality adjusted life years gained were comparable for AA and ENZ. These results were supported by sensitivity analyses. Conclusions: While benefits are similar for OS, AA is cost-saving compared with ENZ for the treatment of patients with mCRPC following treatment with docetaxel.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call