AN ECONOMIC MODEL TO ESTIMATE THE 1-YEAR COSTS AND OUTCOMES IN PATIENTS WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC) TREATED WITH ENZALUTAMIDE PLUS RADIUM-223 (RA-223) OR LUTETIUM-177 VIPIVOTIDE TETRAXETAN (177LU-PSMA-617...
Author(s)
Sreevalsa Appukkuttan, MPH1, Bashir Kalayeh, PharmD, RPh1, Jean Lee, PharmD, MS1, William Ngantung, BS2, Matia Saeedian, PharmD, MS2;
1Bayer, Whippany, NJ, USA, 2BluePath Solutions, Los Angeles, CA, USA
1Bayer, Whippany, NJ, USA, 2BluePath Solutions, Los Angeles, CA, USA
OBJECTIVES: Prostate cancer is the most commonly diagnosed cancer among men, emphasizing the need to consider both costs and clinical benefits in treatment decision-making. This analysis estimated 1-year costs and outcomes for patients with metastatic castration-resistant prostate cancer treated with the combination of Ra-223 and enzalutamide (Ra-223+Enza) or 177Lu-PSMA-617.
METHODS: An economic model was developed using radiographic progression-free survival (rPFS) and overall survival (OS) data extracted from the PEACE-3 (NCT02194842) and PSMAFore (NCT04689828) studies to estimate 1-year health system costs in 2025 United States dollars, time spent in rPFS, and cost per rPFS month. A partitioned survival modeling approach with a 2-week cycle length was used to estimate time spent in each health state. Cost inputs were sourced from published literature and online databases. Given that enzalutamide is subject to price negotiation under the Inflation Reduction Act in 2027, a scenario analysis incorporating the negotiated price published by The Centers for Medicare & Medicaid Services was conducted.
RESULTS: Over 1-year, total costs for Ra-223+Enza and 177Lu-PSMA-617 were $357,229 and $347,976, respectively. Ra-223+Enza yielded 10.8 rPFS months, which was 1.7 months longer than 177Lu-PSMA-617 (9.1 months), resulting in a lower cost per rPFS month ($33,053 vs. $38,393; difference: -$5,340). In the scenario analysis, 1-year costs for Ra-223+Enza decreased to $274,563, which was $73,413 lower than 177Lu-PSMA-617. The cost per rPFS month for Ra-223+Enza reduced to $25,404, increasing the difference to -$12,989.
CONCLUSIONS: Over a 1-year time horizon, Ra-223+Enza achieved a lower cost per rPFS month compared to 177Lu-PSMA-617. Although Ra-223+Enza therapy costs were slightly higher due to continuous treatment with enzalutamide until progression, it stands as a more cost-effective option for extending rPFS months for patients. Future shifts in enzalutamide pricing will only further enhance the Ra-223+Enza treatment cost effectiveness.
METHODS: An economic model was developed using radiographic progression-free survival (rPFS) and overall survival (OS) data extracted from the PEACE-3 (NCT02194842) and PSMAFore (NCT04689828) studies to estimate 1-year health system costs in 2025 United States dollars, time spent in rPFS, and cost per rPFS month. A partitioned survival modeling approach with a 2-week cycle length was used to estimate time spent in each health state. Cost inputs were sourced from published literature and online databases. Given that enzalutamide is subject to price negotiation under the Inflation Reduction Act in 2027, a scenario analysis incorporating the negotiated price published by The Centers for Medicare & Medicaid Services was conducted.
RESULTS: Over 1-year, total costs for Ra-223+Enza and 177Lu-PSMA-617 were $357,229 and $347,976, respectively. Ra-223+Enza yielded 10.8 rPFS months, which was 1.7 months longer than 177Lu-PSMA-617 (9.1 months), resulting in a lower cost per rPFS month ($33,053 vs. $38,393; difference: -$5,340). In the scenario analysis, 1-year costs for Ra-223+Enza decreased to $274,563, which was $73,413 lower than 177Lu-PSMA-617. The cost per rPFS month for Ra-223+Enza reduced to $25,404, increasing the difference to -$12,989.
CONCLUSIONS: Over a 1-year time horizon, Ra-223+Enza achieved a lower cost per rPFS month compared to 177Lu-PSMA-617. Although Ra-223+Enza therapy costs were slightly higher due to continuous treatment with enzalutamide until progression, it stands as a more cost-effective option for extending rPFS months for patients. Future shifts in enzalutamide pricing will only further enhance the Ra-223+Enza treatment cost effectiveness.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE160
Topic
Economic Evaluation
Disease
SDC: Oncology