Abstract

Luteinizing hormone-releasing hormone (LHRH) agonists represent the main treatment for the management of patients with advanced and metastatic prostate cancer (amPC). Leuprolide, LHRH agonist, is used as first-line treatment in amPC. Lutrate Depot 22.5 mg is a novel leuprolide acetate formulation, offering a unique double control delivery system. The aim of this study was to evaluate the economic implications of leuprolide acetate 3-monthly (3M) depot formulations, from payer perspective in Greece (EOPYY). A traditional budget-impact model with a 5-year time-horizon was developed. Epidemiological data were obtained from literature and were validated by a local clinical expert. The target population consisted of newly diagnosed amPC patients, since no treatment changes are envisaged in patients with testosterone levels <50ng/dl or 1.735nmol/L. The analysis included currently available leuprolide acetate 3M formulations (Elityran and Leuprol 11.25 mg). Market share predictions were based on internal market research. The model incorporated only drug acquisition costs, obtained from the National Price Bulletin, applying the mandatory price discounts, rebates and clawbacks. The estimated number of patients eligible to receive leuprolide was 914 in the first model year and 4,883 patients over a 5-year horizon. About 414 patients (44% of the total population) was predicted to receive treatment with Lutrate Depot in the first year and 2,197 patients over 5-years. Introduction of Lutrate Depot in the market would lead to budget savings of €5,171 to €117,747 in the first and fifth model-years, respectively. The cumulative budget-impact over 5-years resulted in cost-savings of €129,071 for the payer (€6,194,671 vs €6,323,742). According to published data LHRH agonists have similar clinical efficacy and safety. The results of the model suggest that Lutrate Depot 22.5mg over the available 3M depot formulations could lead to considerable savings for EOPYY; consisting Lutrate Depot 22.5mg an alternative cost-saving treatment option for eligible amPC patients in Greece.

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