Cost-Utility Analysis of Enzalutamide for Patients with Previously Treated Metastatic Castration-Resistant Prostate Cancer (MCRPC)

Abstract

A89treatment was based on stage and prognostic score. Other model inputs were literature-derived or assumption-based. Costs and QALYs were discounted at a 3% annual rate. One-way and probabilistic sensitivity analyses examined the relative impact of model inputs. Results: In the base case scenario 44% of patients received ACT using the prognostic test vs. 38% based on SoC. Total costs were $131,287 and $125,594 and total QALYs gained were 5.33 and 5.16 for the prognostic test and SoC, respectively. The incremental cost-effectiveness ratio (ICER) for the prognostic test was $34,055/QALY gained. One-way sensitivity analyses indicated the probability of receiving ACT for high-risk, stage Ib patients and the ACT treatment benefit were the largest drivers of cost-effectiveness. The probabilistic sensitivity analysis ICER was $44,196/QALY gained. The prognostic test was costeffective in 51.1% of the simulations at a willingness-to-pay threshold of $50,000/ QALY gained. ConClusions: The results of this study suggest that using myPlan Lung Cancer to guide ACT decisions is cost-effective compared to a SoC approach according to globally accepted thresholds. PCN124 EstimatioN of thE Quality adjustEd ProgrEssioN frEE survival of thE trEatmENt arms of thE BolEro-2 trial