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ASCO 2018: First comparison of two prostate cancer therapies finds vastly different cost-effectiveness between strategies

In recent years the Food and Drug Administration has approved several new drugs for men with newly diagnosed metastatic prostate cancer.

A new study compares the cost-effectiveness of intravenous docetaxel (DC) and daily pill abiraterone acetate plus prednisone (AAP) and analyzes progression free and overall survival for each.

Chethan Ramamurthy, MD, a haematology/oncology fellow at Fox Chase Cancer Center, presented the findings as part of the ASCO 2018 annual meeting along with co-authors from Fox Chase.

Previous randomized trials have demonstrated that both DC and AAP can prolong survival in conjunction with androgen deprivation therapy for men with newly diagnosed metastatic prostate cancer.

This study projects cost of each treatment relative to the amount of additional quality-adjusted life years (QALYs), a measure of how well and long patients live.

Adjusting for quality of life included comparing the side effect profiles of each drug, the average length of time on a therapy, and factoring in the likelihood and cost of additional therapy once the disease did progress.

Ramamurthy and his coauthors found that DC would add about one-third of one year of progression-free survival at a cost of approximately $40,000 per QALY, and AAP would add about one-half of one year at a cost of over $400,000 per QALY.

Thus, while AAP may offer slightly more time before progression, it costs more than 10 times as much for that gain. Importantly, both drugs showed similar improvements in overall survival, despite the modest increase in progression-free time in patients taking AAP.

“Cost is one factor among many when physicians decide among treatment options,” Ramamurthy said. “Our study compared the cost-effectiveness of these two highly efficacious and generally equivalent therapies and found a tremendous cost difference between them, despite very similar overall survival benefits.”

Source: Fox Chase Cancer Center



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