COST-UTILITY OF THERAPY WITH 177LU-PSMA: SYSTEMATIC REVIEW OF THE LITERATURE
Author(s)
Marylin Acuña Hernandez, Specialist Nuclear Medicine health economic eval1, Paula Alejandra Mendez Mercado, Hospital Physician2, Olga Liset Sanchez Orduz, Specialist in Nuclear Medicine3;
1Universidad de Antioquia - Instituto Nacional de Cancerología, Bogotá, Colombia, 2Los Cobos Medical Center, Bogotá, Colombia, 3SPECT Medicina Nuclear SAS, Bucaramanga, Colombia
1Universidad de Antioquia - Instituto Nacional de Cancerología, Bogotá, Colombia, 2Los Cobos Medical Center, Bogotá, Colombia, 3SPECT Medicina Nuclear SAS, Bucaramanga, Colombia
OBJECTIVES: Conduct a systematic review of the literature on cost-utility studies of 177Lu-PSMA therapy compared with taxane-based management and standard therapy in patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC).
METHODS: A literature search was conducted using MeSH, DeCS, and free terms combined with Boolean operators in the following databases: PUBMED, Embase, Cochrane, INAHTA, Lilacs, OpenGrey, Renata, and Google Scholar. A total of 470 articles were retrieved; after removing duplicates and studies without full text, 6 articles remained, to which the CHEERS criteria were applied to evaluate methodological quality.
RESULTS: The literature reported 5 complete economic evaluations and 1 incomplete regarding the costs of 177Lu-PSMA therapy in patients diagnosed with castration-resistant prostate carcinoma, comparing it with standard management or taxanes. Four of the studies found the former alternative to be more costly in countries such as Norway, Canada, the Netherlands, and Colombia, but not in the United States and Germany. Notably, some full economic evaluations published in countries such as Canada did not include data required for health economic assessments within their reports, thereby limiting interpretation. However, in all scenarios, 177Lu-PSMA therapy was associated with higher QALY gains.
CONCLUSIONS: [¹⁷⁷Lu]PSMA therapy consistently demonstrates improved quality-adjusted survival compared with Cabazitaxel in mCRPC. Despite higher upfront costs in several settings, the incremental benefits in QALY gains support its cost-effectiveness within or near commonly accepted willingness-to-pay thresholds. However, methodological heterogeneity and incomplete reporting in some evaluations highlight the need for standardized economic modeling and local
METHODS: A literature search was conducted using MeSH, DeCS, and free terms combined with Boolean operators in the following databases: PUBMED, Embase, Cochrane, INAHTA, Lilacs, OpenGrey, Renata, and Google Scholar. A total of 470 articles were retrieved; after removing duplicates and studies without full text, 6 articles remained, to which the CHEERS criteria were applied to evaluate methodological quality.
RESULTS: The literature reported 5 complete economic evaluations and 1 incomplete regarding the costs of 177Lu-PSMA therapy in patients diagnosed with castration-resistant prostate carcinoma, comparing it with standard management or taxanes. Four of the studies found the former alternative to be more costly in countries such as Norway, Canada, the Netherlands, and Colombia, but not in the United States and Germany. Notably, some full economic evaluations published in countries such as Canada did not include data required for health economic assessments within their reports, thereby limiting interpretation. However, in all scenarios, 177Lu-PSMA therapy was associated with higher QALY gains.
CONCLUSIONS: [¹⁷⁷Lu]PSMA therapy consistently demonstrates improved quality-adjusted survival compared with Cabazitaxel in mCRPC. Despite higher upfront costs in several settings, the incremental benefits in QALY gains support its cost-effectiveness within or near commonly accepted willingness-to-pay thresholds. However, methodological heterogeneity and incomplete reporting in some evaluations highlight the need for standardized economic modeling and local
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE51
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology, STA: Multiple/Other Specialized Treatments