Real-world clinical outcomes and cost estimates of metastatic castration-resistant prostate cancer treatment: does sequencing of taxanes and androgen receptor-targeted agents matter?

Pereira-Salgado, A; Anton, A; Franchini, F; Mahar, RK; Kwan, EM; Wong, S; Shapiro, J; Weickhardt, A; Azad, AA; Spain, L; Gunjur, A; Torres, J; Parente, P; Parnis, F; Goh, J; Steer, C; Brown, S; Gibbs, P; Tran, B; IJzerman, M

Author(s): Pereira-Salgado, A; Anton, A; Franchini, F; Mahar, RK; Kwan, EM; Wong, S; Shapiro, J; Weickhardt, A; Azad, AA; Spain, L; Gunjur, A; Torres, J; Parente, P; Parnis, F; Goh, J; Steer, C; Brown, S; Gibbs, P; Tran, B; IJzerman, M;
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
Publisher's Version: https://doi.org/10.1080/14737167.2023.2161048
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-06-13 07:55:11

Last Modified: 2023-06-13 07:56:08