Presentation (CTI)

OBJECTIVES: To assess the cost-utility of [177Lu]PSMA compared to Cabazitaxel in patients with mCRPC, from the perspective of the Colombian General Health Social Security System.
METHODS: A partitioned survival model was developed using a 24-month time horizon, monthly cycles, and a 5% annual discount rate. Overall survival (OS) and progression-free survival (PFS) curves were fitted using Weibull distributions. Cost data were obtained from SISPRO (CUPS), SISMED, the national price thermometer, and supplier records. Utility values were sourced from international literature. Both deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: [177Lu]PSMA yielded 0.717 QALYs compared to 0.649 with Cabazitaxel. The incremental cost was COP $11,237,696, resulting in an incremental cost-effectiveness ratio (ICER) of COP $167,002,673 per QALY—exceeding the national willingness-to-pay threshold of COP $87 million. In the probabilistic analysis, [177Lu]PSMA was dominant in 100% of simulations.
CONCLUSIONS: Although not cost-effective under average deterministic assumptions, [177Lu]PSMAdemonstrated greater clinical benefit and efficiency in real-world scenarios. Policy recommendations include exploring price negotiation strategies, promoting domestic radiopharmaceutical production, and strengthening Colombia’s regulatory framework for nuclear medicine.