MP70-12 AN INDIRECT TREATMENT COMPARISON AND COST-EFFECTIVENESS ANALYSIS OF ABIRATERONE ACETATE AND ENZALUTAMIDE FOR THE TREATMENT OF METASTATIC CASTRATION-RESISTANT PROSTATE CANCER POST CHEMOTHERAPY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2014MP70-12 AN INDIRECT TREATMENT COMPARISON AND COST-EFFECTIVENESS ANALYSIS OF ABIRATERONE ACETATE AND ENZALUTAMIDE FOR THE TREATMENT OF METASTATIC CASTRATION-RESISTANT PROSTATE CANCER POST CHEMOTHERAPY Melissa Thompson, Tracy Li, Mary Beth Todd, Margaret K. Yu, Thian Kheoh, Jianming He, and Ryan Saadi Melissa ThompsonMelissa Thompson More articles by this author , Tracy LiTracy Li More articles by this author , Mary Beth ToddMary Beth Todd More articles by this author , Margaret K. YuMargaret K. Yu More articles by this author , Thian KheohThian Kheoh More articles by this author , Jianming HeJianming He More articles by this author , and Ryan SaadiRyan Saadi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2211AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Abiraterone acetate (AA) and enzalutamide (ENZ) are 2 new treatment options for patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel-based chemotherapy. Presently, there is great 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 versus ENZ. METHODS The PICO (population, intervention, comparison, and outcomes) construct was used to assess the comparability of the pivotal phase 3 trials COU-AA-301 for AA and AFFIRM for ENZ. An indirect treatment comparison (ITC) was conducted using the Bucher method and Bayesian statistics. A survival-based Markov cohort model with 3 health states (progression-free, progressed, and death) was developed to estimate cost-effectiveness over a lifetime horizon. Results from the ITC were used to inform OS transitions within the model. Since the price of ENZ was publicly available only in the United States (US) at the time of the analysis, US drug acquisition costs were used. Average wholesale prices for a 30-day supply of AA and ENZ were $7674 and $8940, respectively. One-way sensitivity analyses were performed for all probability, utility, and cost values incorporated into the model. RESULTS The results of the ITC showed no significant difference in overall survival (OS) for AA versus ENZ (hazard ratio = 0.95; 95% confidence interval: 0.71-1.26) after accounting for important differences in comparators and background treatments. In the base case of the economic analysis, AA was found to provide an annual cost savings of $13,322 per patient versus ENZ, primarily due to higher acquisition costs of ENZ. Quality-adjusted life years gained were comparable for AA and ENZ. These results were supported by sensitivity analyses. CONCLUSIONS The results of this ITC showed that AA and ENZ have similar efficacy in terms of OS in mCRPC patients post chemotherapy. Despite this similarity, AA is cost-saving compared with ENZ in the treatment of this population in the US. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e810 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Melissa Thompson More articles by this author Tracy Li More articles by this author Mary Beth Todd More articles by this author Margaret K. Yu More articles by this author Thian Kheoh More articles by this author Jianming He More articles by this author Ryan Saadi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...