Budget impact model (BIM) to evaluate treatment costs associated with variable utilization rates of cabazitaxel in metastatic castration-resistant prostate cancer (mCRPC).

Abstract

e18321 Background: Cabazitaxel (CBZ) is a microtubule inhibitor indicated in combination with prednisone for treatment of patients with mCRPC previously treated with a docetaxel (DOC)-containing regimen. Recently published results of the PROSELICA trial may provide the basis for changing utilization rates of CBZ. Methods: A BIM was developed to project the overall costs of varying utilization rates of post-DOC treatment modalities for the management of mCRPC. Treatment costs of two dosage schema for CBZ were compared to abiraterone acetate, enzalutamide, and radium-223. Prevalence of mCRPC was estimated using US Census and population modeling data. Medication costs were derived from published benchmarks; dosing/monitoring information from prescribing information; and duration of therapy from published trials. Rates and costs of Grade 3 / 4 adverse events (AEs) per published trials were also incorporated. Results: In a hypothetical 1 million member US health plan, 100 pts are estimated to receive 2nd line (2L) treatment for mCRPC. Reported utilization rates for 2L agents calculate to a PMPM of $0.623. Following publication of the PROSELICA study, modeling a potential increase in CBZ 20 mg/m2 utilization from 0% to 7% and modeling a 12% to 16% utilization rate change for CBZ 25 mg/m2, costs are projected to decrease by -$0.022 PMPM or $265,033 over a one year period. Although AE costs of management calculate higher for the CBZ doses, lower monitoring and drug acquisition costs contribute to account for these findings (Table 1). Conclusions: Increasing utilization rates of CBZ in 2L mCRPC can result in a slight cost decrease due to variation in CBZ dosing and AE rates, and lower monitoring and acquisition costs. [Table: see text]