Real-world clinical outcomes and cost estimates of metastatic castration-resistant prostate cancer treatment: does sequencing of taxanes and androgen receptor-targeted agents matter?
Details
Publication Year 2023-02,Volume 23,Issue #2,Page 231-239
Journal Title
Expert Review of Pharmacoeconomics & Outcomes Research
Publication Type
Research article
Abstract
INTRODUCTION: Health economic outcomes of real-world treatment sequencing of androgen receptor-targeted agents (ARTA) and docetaxel (DOC) remain unclear. 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. 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. CONCLUSION: ICERs show ARTA had improved clinical benefit compared to DOC but at higher cost. There were no significant cost differences between combined sequences.
Publisher
Taylor & Francis
Keywords
Male; Humans; Taxoids/pharmacology; Receptors, Androgen/therapeutic use; *Prostatic Neoplasms, Castration-Resistant/drug therapy/pathology; Australia; *Antineoplastic Agents/pharmacology/therapeutic use; Docetaxel; Treatment Outcome; Antineoplastic Combined Chemotherapy Protocols/pharmacology/therapeutic use; Health economics; metastatic castration-resistant prostate cancer; prostate cancer; time-to-treatment failure; treatment costs; treatment sequences
Department(s)
Health Services Research; Medical Oncology
PubMed ID
36541133
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Creation Date: 2023-06-13 07:55:11
Last Modified: 2023-06-13 07:56:08

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