AVOIDABLE DIRECT COSTS IN PATIENTS WITH METASTATIC HORMONE-SENSITIVE PROSTATE CANCER (MHSPC) TREATED WITH DAROLUTAMIDE: A REAL-WORLD EVIDENCE FROM A MULTICENTER STUDY IN COLOMBIA
Author(s)
Manuel R. Roa, MD, MSc1, Claudia A. López-Cabra, MD, MSc1, Jose Daza-Vergara, MD, MSc2, Uriel Palacios Barahona, PhD2, Fernando E. Salcedo Mejía, BEc, MSc3, Lina M. Moyano, BEcon4, Rosmery V. Barroso, BEcon4, Liliana Torres, MD, MSc1, RAY MANNEH, MD, Oncologist5, Sergio I. Prada, PhD6, Angela Maria Paredes, MD7, Nelson R. Alvis Zakzuk, MBA4, Nelson José Alvis Zakzuk, MSc8;
1Bayer, Bogota, Colombia, 2Hospital Universitario Mayor Mederi - Universidad del Rosario, Bogota, Colombia, 3ALZAK - Universidad Tecnologica de Bolivar, Cartagena, Colombia, 4ALZAK, Cartagena, Colombia, 5Sociedad de Oncologia y Hematologia del Cesar, Valledupar, Colombia, 6Fundación Valle del Lili - Universidad ICESI Centro PROESA, Cali, Colombia, 7CEO Grupo Uroexpertos SAS, Medellin, Colombia, 8Universidad de la Costa, Barranquilla, Colombia
1Bayer, Bogota, Colombia, 2Hospital Universitario Mayor Mederi - Universidad del Rosario, Bogota, Colombia, 3ALZAK - Universidad Tecnologica de Bolivar, Cartagena, Colombia, 4ALZAK, Cartagena, Colombia, 5Sociedad de Oncologia y Hematologia del Cesar, Valledupar, Colombia, 6Fundación Valle del Lili - Universidad ICESI Centro PROESA, Cali, Colombia, 7CEO Grupo Uroexpertos SAS, Medellin, Colombia, 8Universidad de la Costa, Barranquilla, Colombia
OBJECTIVES: We aimed to estimate the potential impact of avoidable costs associated with darolutamide use in patients with mHSPC treated across four centers in Colombia
METHODS: A cost analysis was performed. Efficacy parameters were obtained from the ARANOTE clinical trial, which reported a 46% lower risk of radiological progression in darolutamide users. Direct medical costs were obtained from four centers in Bogota, Apartado, Cali, and Valledupar from patients with mHSPC treated; frequency of services sourced from invoicing and costs from public databases (ISSS 2001 + inflation and SISMED). We developed a partitioned survival economic model based on radiological progression-free survival (rPFS) to estimate the potential avoidable costs associated with delayed progression to mCRPC. A Monte Carlo simulation with 5,000 iterations was conducted, randomizing patients into darolutamide and control groups. Potential avoidable costs were defined as those related to symptomatic skeletal events (SSE), radiotherapy, hospitalizations, and other procedures or interventions linked to disease progression. The total accumulated costs were estimated over a 4-year period using progression-free survival probabilities from the ARANOTE trial. Costs were converted to USD using a March 2025 exchange rate of COP$4,192.57
RESULTS: Using cost data for 214 patients in the mHSPC state, the model estimated the potential avoidable costs of progression/delay to the mCRPC state. Patients who received darolutamide would have cumulative median costs of US$1,851,267 (95% CI: US$1,369,895 - US$2,689,457). On the other hand, those who did not receive the treatment had average accumulated costs of US$2,653,658 (95% CI: US$1,607,955 - US$4,829,090). Hence, the use of darolutamide in patients with mHSPC implies a reduction of 30,2% (95% CI: -45,5%; -10,0%) in the cumulative costs
CONCLUSIONS: The darolutamide-treated group showed lower annual costs than the best supportive care patient group due to a lower risk of progression to disease, implying an important set of health expenditures that could be avoided/delayed
METHODS: A cost analysis was performed. Efficacy parameters were obtained from the ARANOTE clinical trial, which reported a 46% lower risk of radiological progression in darolutamide users. Direct medical costs were obtained from four centers in Bogota, Apartado, Cali, and Valledupar from patients with mHSPC treated; frequency of services sourced from invoicing and costs from public databases (ISSS 2001 + inflation and SISMED). We developed a partitioned survival economic model based on radiological progression-free survival (rPFS) to estimate the potential avoidable costs associated with delayed progression to mCRPC. A Monte Carlo simulation with 5,000 iterations was conducted, randomizing patients into darolutamide and control groups. Potential avoidable costs were defined as those related to symptomatic skeletal events (SSE), radiotherapy, hospitalizations, and other procedures or interventions linked to disease progression. The total accumulated costs were estimated over a 4-year period using progression-free survival probabilities from the ARANOTE trial. Costs were converted to USD using a March 2025 exchange rate of COP$4,192.57
RESULTS: Using cost data for 214 patients in the mHSPC state, the model estimated the potential avoidable costs of progression/delay to the mCRPC state. Patients who received darolutamide would have cumulative median costs of US$1,851,267 (95% CI: US$1,369,895 - US$2,689,457). On the other hand, those who did not receive the treatment had average accumulated costs of US$2,653,658 (95% CI: US$1,607,955 - US$4,829,090). Hence, the use of darolutamide in patients with mHSPC implies a reduction of 30,2% (95% CI: -45,5%; -10,0%) in the cumulative costs
CONCLUSIONS: The darolutamide-treated group showed lower annual costs than the best supportive care patient group due to a lower risk of progression to disease, implying an important set of health expenditures that could be avoided/delayed
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE358
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology