Cost-Utility Analysis of Lu-PSMA Therapy Compared to Taxane-Based Cabazitaxel in Patients Diagnosed With Metastatic Castration-Resistant Prostate Cancer: A Colombian Health System Perspective
Author(s)
Marylin Acuña Hernandez, MSc1, Aurelio Mejía, MSc2.
1Universidad de Antioquia, Medellin, Colombia, 2Universidad de Antioquia, Bogota, Colombia.
1Universidad de Antioquia, Medellin, Colombia, 2Universidad de Antioquia, Bogota, Colombia.
OBJECTIVES: Introduction: Metastatic castration-resistant prostate cancer (mCRPC) represents a high clinical and economic burden. In this setting, treatment alternatives such as Cabazitaxel and 177Lu-PSMA are available. Objective: Estimate the cost-utility of 177Lu-PSMA compared to Cabazitaxel in patients with mCRPC who have progressed after a taxane-based therapy, from the perspective of the Colombian General Social Health Security System
METHODS: A three-state partitioned survival model was developed using data from the TheraP clinical trial. Survival curves were fitted using the Weibull function, selected for its superior statistical performance (AIC). Costs were obtained from SISPRO, SISMED, the Price Thermometer (base year 2022, adjusted to 2024), and provider quotations. A discount rate ranging from 0% to 5% was applied. Results were calculated using the INES tool and Python.
RESULTS: 177Lu-PSMA yielded 0.717 QALYs at a cost of COP $130,261,259, while Cabazitaxel produced 0.649 QALYs at a cost of COP $110,001,803. The ICUR was COP $301,074,460 per QALY, significantly exceeding the national willingness-to-pay threshold of COP $87,000,000. Although 177Lu-PSMA provided greater quality-adjusted health benefits, neither therapy was cost-effective.
CONCLUSIONS: Both therapies exceed the cost-utility threshold in Colombia; however, 177Lu-PSMA is associated with higher QALY gains. Strategies should be explored to facilitate the adoption of this radiopharmaceutical within the Colombian healthcare system.
METHODS: A three-state partitioned survival model was developed using data from the TheraP clinical trial. Survival curves were fitted using the Weibull function, selected for its superior statistical performance (AIC). Costs were obtained from SISPRO, SISMED, the Price Thermometer (base year 2022, adjusted to 2024), and provider quotations. A discount rate ranging from 0% to 5% was applied. Results were calculated using the INES tool and Python.
RESULTS: 177Lu-PSMA yielded 0.717 QALYs at a cost of COP $130,261,259, while Cabazitaxel produced 0.649 QALYs at a cost of COP $110,001,803. The ICUR was COP $301,074,460 per QALY, significantly exceeding the national willingness-to-pay threshold of COP $87,000,000. Although 177Lu-PSMA provided greater quality-adjusted health benefits, neither therapy was cost-effective.
CONCLUSIONS: Both therapies exceed the cost-utility threshold in Colombia; however, 177Lu-PSMA is associated with higher QALY gains. Strategies should be explored to facilitate the adoption of this radiopharmaceutical within the Colombian healthcare system.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE296
Topic
Economic Evaluation, Real World Data & Information Systems
Disease
Oncology