Cost-Minimization and Budget Impact Analysis of Abiraterone (Tarosyn® and Avitosyn®) as Second Line Treatment for Metastatic Prostate Cancer Resistant to Castration in Mexico

OBJECTIVES: Advanced prostate cancer has a poor prognosis. It can turn into castration-resistant prostate cancer (CRPC) within 1–2 years and easily progress to metastatic CRPC (mCRPC). Evidence indicates that treatment with abiraterone, cabazitaxel, or enzalutamide in patients with mCRPC, demonstrated an increase in survival by approximately 3-5 months and recommends the use of all three drugs equally. The objective of this analysis was to estimate the poten­tial reduction in costs and the identification of the net bud­get impact of the adoption of new Abiraterone (Tarosyn® and Avitosyn®) as 2nd line treatment of mCRPC at the Mexican Social Security Institute (IMSS) in Mexico.

METHODS: A Cost Minimization Analysis (CMA) was conducted along with a 5-year Budget Impact Analysis (BIA). BIA assumptions include that new Abiraterone (Tarosyn® and Avitosyn®) would gradually gain market share until it reaches 100% of new or switching patients in the fifth year. All costs are in 2024 USD.

RESULTS: In the CMA, the calculated costs per year treatment per patient were $4,954.33 for new Abiraterone (Tarosyn® and Avitosyn®), basal abiraterone $11,644.13, cabazitaxel $9,252.93 and enzalutamide $12,719.45. Savings associated to new Abiraterone (Tarosyn® and Avitosyn®) are in average $6,251.17 per patient. Probabilistic sensitivity analysis was conducted with 1,000 random simulations, with new Abiraterone (Tarosyn® and Avitosyn®) being less costly than its comparators in all simulations. Additionally, the BIA result indicates that new Abiraterone (Tarosyn® and Avitosyn®) is a cost-saving intervention, with an average predicted five-year saving-impact of -$984,970 for every 100-patient cohort.

CONCLUSIONS: Results obtained by both CMA and BIA, conclu­ded that the adoption of new Abiraterone (Tarosyn® and Avitosyn®) by the IMSS in the Mexican public healthcare system has a positive impact on its budget, considering the low cost when compared to other metastatic castration-resistant prostate cancer drugs without any prejudice regarding efficacy and safety parameters.