Olaparib as first line in BRCA-mutated advanced ovarian carcinoma: Is it cost-effective in Spain?

Abstract

Our results suggest that olaparib could delay disease progression and improve OS by 2 years vs. no maintenance treatment.• Treatment with olaparib resulted in a gain of 2.00 QALYs vs. no maintenance treatment, at an ICER of €14,653,2/QALY. • First-line maintenance with olaparib is cost-effective in advanced HGSOC patients with BRCA mutations in Spain.

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

“…Characteristics of the included studies are shown in presented in S2 Table . Overall, 19 studies were published after June, 2019, including 9 in 2020 [ 22 – 30 ], 7 in 2021 [ 31 – 37 ], and 3 2022 [ 38 – 40 ]. Studies were conducted from the United States (US) (n = 13) [ 16 – 20 , 23 – 28 , 38 , 40 ], China (n = 5) [ 27 , 30 , 32 , 39 , 40 ], Singapore (n = 2) [ 31 , 34 ], Japan [ 21 ], Italy [ 22 ], and Spain [ 33 ].…”

“…PARPi evaluated in these studies included olaparib [ 16 – 18 , 20 – 22 , 25 – 28 , 30 – 32 , 34 – 40 ], niraparib [ 18 – 20 , 23 , 26 , 28 ], rucaparib [ 20 , 28 ], talazoparib [ 33 ], and veliparib [ 24 ]. Modeling methods employed included the Markov model (n = 11) [ 16 , 21 , 22 , 24 , 28 , 30 , 32 , 36 , 37 , 39 , 40 ], decision tree model (n = 6) [ 17 – 20 , 23 , 35 ], partitional survival model (n = 7) [ 25 , 27 , 31 , 33 , 34 , 38 ], and the non-Markov alternatives (n = 1) [ 26 ].…”

“…Apart from Wolford et al [ 28 ], all other authors performed uncertainty analysis. Among them, authors from 13 studies conducted one-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA) [ 16 , 20 – 22 , 26 , 27 , 30 , 32 , 34 , 37 , 39 , 40 ], those from six studies conducted OWSA, PSA and scenario analysis (SA) [ 18 , 25 , 31 , 35 , 36 , 38 ], those from one study conducted OWSA, two-way sensitivity analysis (TWSA) and PSA [ 24 ], those from three studies only conducted OWSA (n = 3) [ 19 , 23 , 33 ], and those from one only performed SA [ 17 ].…”

“…Cost-effectiveness outcomes are summarized in Table 1 and S3 Table . Among 17 studies on the cost-effectiveness of PARPi maintenance therapy for ovarian cancer, eight were for platinum-sensitive recurrent ovarian cancer [ 16 – 20 , 31 , 35 , 39 ] and nine were for first-line platinum-based chemotherapy for newly diagnosed ovarian cancer [ 22 – 26 , 28 , 34 , 37 , 38 ].…”

“…The cost-effectiveness of PARPi was primarily affected by the costs of PARPi [ 16 – 19 , 22 – 25 , 27 , 30 – 33 , 35 , 36 ], survival time including PFS and OS [ 16 – 18 , 20 , 21 , 23 – 25 , 27 , 35 , 36 ], health state utilities [ 20 , 23 , 27 , 32 , 36 ] and discount rate [ 25 , 31 , 32 , 34 , 37 ]. Cost of PARPi plays as a critical factor.…”