Background. Enzalutamide and abiraterone are hormonal antineoplastic drugs used for treatment of metastatic castration-resistant prostate cancer (mCRPC). Both drugs were proved to be effective in randomized controlled trials.Objective. Pharmacoeconomic analysis of using enzalutamide and abiraterone for treatment of chemotherapy-naive patients with mCRPC from the perspective of Russian healthcare system in 2019.Materials and methods. We proposed a Markov model of mCRPC progression on three treatment options: enzalutamide, abiraterone or active monitoring with no antineoplastic treatment in the 1st line setting. The model was based on indirect treatment comparison of considered drugs. Modelling period was 5 years. The model was used for calculating per patient medical costs, and further cost–effectiveness, cost–utility and budget impact analysis.Results. Monthly medication costs of enzalutamide were 183 551 rubles, which were 23 766 rubles (11.5 %) less than for abiraterone (207 224 rubles). 5-year total medical costs for enzalutamide were 5633 thousand rubles per patient, that were 67 499 rubles (1.2 %) less than for abiraterone. Incremental cost/effectiveness ratio for enzalutamide vs active monitoring was 533 thousand rubles per one life-month gained, compared to 623 thousand rubles per one life-month gained for abiraterone. If 7328 mCRPC chemotherapy-naive patients receive enzalutamide, Russian government healthcare spending will be 495 million rubles (1.2 %) less, compared to abiraterone.Conclusion. With comparable costs enzalutamide is a cost-effective treatment option of chemotherapy-naive mCRPC patients, compared to abiraterone, in Russia.
Ten years after CE, the group with the baseline clinical manifestations of CL and poorer QOL showed a lower incidence of APS mainly due to the reduced incidence of biliary pains and the baseline asymptomatic group exhibited a rise in the incidence of APS due to the appearance of biliary pains and dyspepsia.
Background. Prostate cancer is one of the most common malignant diseases among men. Until recently, the most common treatment of nonmetastatic castration-resistant prostate cancer (nmCRPC) in Russia was to continue previously started hormonal therapy. Enzalutamide is a second-generation anti-androgen indicated for treatment of CRPC, regardless of a patient’s metastatic status, which significantly increases metastasis-free survival in nmCRPC compared with androgen deprivation therapy (ADT).Objective: to evaluate the incremental cost-effectiveness ratio (ICER) of enzalutamide use in patients with nmCRPC and the ICER of abiraterone as the first-line therapy for mCRPC from the Russian healthcare system perspective.Materials and methods. Standard ADT regimens for nmCRPC were used as a comparator as it was the only approved treatment for nmCRPC in Russia. We proposed a Markov model of CRPC progression on enzalutamide plus ADT (hereinafter enzalutamide) or ADT based on PROSPER trial data. Model was used to calculate progression-free life years and costs of nmCRPC and post-progression CRPC treatment. Simulation period was 5 years with one cycle of 1 month. In the “cost–effectiveness” analysis, we calculated enzalutamide ICER compared to ADT. In addition, we calculated ICER for abiraterone plus ADT and prednisolone (hereinafter abiraterone) vs ADT + prednisolone in the first-line therapy of metastatic CRPC (mCRPC) as a benchmark. In both cases, time to disease progression over a 5-year period was used as an efficacy criteria.Results. According to the Markov model, progression-free life-years gained for enzalutamide were 3.12 years compared to 1.79 for ADT within a 5-year period. The average enzalutamide therapy costs were 7,989,475.8 rubles/1 patient for 5 years, which were 5,716,983.5 rubles higher than when using ADT (2,272,492.3 rubles). ICER for enzalutamide (vs ADT) was 4,307,136.3 rubles per one progression-free life-year gained. ICER for abiraterone in the first line of mCRPC treatment (vs ADT + prednisolone) was 6,191,617.4 rubles per one progression-free life-year gained.Conclusion. In the Russian healthcare system, ICER for enzalutamide in nmCRPC was 4,307,136.3 rubles and the ICER for abiraterone in mCRPC was 6,191,617.4 rubles.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.