A Cost-Effectiveness Study for Comparing Three Systematic Treatments for Hormone-Sensitive Prostate Cancer in Sweden
Author(s)
Sun Sun, PhD.
Research Fellow, Umeå University, Umeå, Sweden.
Research Fellow, Umeå University, Umeå, Sweden.
OBJECTIVES: Our study addresses the cost-effectiveness of treatments for hormone-sensitive prostate cancer (HSPC) in Sweden, focusing on androgen deprivation therapy (ADT) in combination with docetaxel (DOC) or abiraterone (ABI), and the novel triple systemic therapy (ADT+DOC+ABI).
METHODS: Utilizing a discrete Markov state-transition model with the "Heemod" package in R, our analysis incorporates health states of HSPC under treatment, castration-resistant prostate cancer (CRPC), terminal illness, and death. Costs, assessed from a societal perspective, draw from Swedish datasets, and transition probabilities from HSPC to CRPC are derived from STAMPEDE and PEACE-1 trials. A series of one-way sensitivity analyses and probabilistic sensitivity analyses (PSA) with 1,000 repetitions were performed, to test the robustness of the results.
RESULTS: ResultsTo the best of our knowledge, this is the first CEA that evaluates the newly launched triple therapy, and the first one performs ABI and DOC comparison by utilizing data from head-to-head comparisons. The cost data are based on Swedish real-world evidence, and costs for palliative and informal care were considered. Results indicate that ADT+DOC+ABI is cost-effective, extending overall survival (OS) and delaying progression to CRPC compared to ADT+DOC. Limited differences were found between ADT+DOC vs. ADT+ABI. Sensitivity analyses confirm the robustness of our conclusions. However, challenges arise in comparing ADT+DOC+ABI vs. ADT+ABI due to a lack of clinical trial data, and information from ADT+DOC vs. ADT+ABI is constrained.
CONCLUSIONS: Our research pioneers the evaluation of the newly launched triple therapy, providing the first comparison of ABI and DOC through head-to-head data. The cost data, rooted in Swedish real-world evidence, encompass palliative and informal care costs.
METHODS: Utilizing a discrete Markov state-transition model with the "Heemod" package in R, our analysis incorporates health states of HSPC under treatment, castration-resistant prostate cancer (CRPC), terminal illness, and death. Costs, assessed from a societal perspective, draw from Swedish datasets, and transition probabilities from HSPC to CRPC are derived from STAMPEDE and PEACE-1 trials. A series of one-way sensitivity analyses and probabilistic sensitivity analyses (PSA) with 1,000 repetitions were performed, to test the robustness of the results.
RESULTS: ResultsTo the best of our knowledge, this is the first CEA that evaluates the newly launched triple therapy, and the first one performs ABI and DOC comparison by utilizing data from head-to-head comparisons. The cost data are based on Swedish real-world evidence, and costs for palliative and informal care were considered. Results indicate that ADT+DOC+ABI is cost-effective, extending overall survival (OS) and delaying progression to CRPC compared to ADT+DOC. Limited differences were found between ADT+DOC vs. ADT+ABI. Sensitivity analyses confirm the robustness of our conclusions. However, challenges arise in comparing ADT+DOC+ABI vs. ADT+ABI due to a lack of clinical trial data, and information from ADT+DOC vs. ADT+ABI is constrained.
CONCLUSIONS: Our research pioneers the evaluation of the newly launched triple therapy, providing the first comparison of ABI and DOC through head-to-head data. The cost data, rooted in Swedish real-world evidence, encompass palliative and informal care costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE13
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Oncology