OBJECTIVES : Prostate cancer (PCa) is one of the most common cancer and one of the leading causes of mortality among males worldwide. This study was to determine the cost-effectiveness of the treatment of prostate cancer with degarelix compared to luteinizing hormone-releasing hormone (LHRH) agonists in China.

METHODS : A European cost-effectiveness model was adapted from the perspective of Chinese healthcare system, evaluating monthly degarelix against monthly gosereline/leuprorelin for the treatment of patients with prostate cancer. Patient characteristics and efficacy information was derived from a global CS21 clinical trial and cost information was adjusted into Chinese setting. Cardiovascular and musculoskeletal related adverse events were simulated in the model. The intention-to-treat (ITT) population and a PSA level >20 ng/mL sub-group were analyzed in the model. One-way Sensitivity analyses and probabilistic sensitivity analyses were conducted to examine the robustness of the model.

RESULTS : In the base-case analysis using the original retail price, the incremental cost of treatment with degarelix, compared to goserelin and leuprorelin, was ¥18,587.98 and ¥35,709.57 respectively, with an incremental quality-adjusted life-year (QALY) of 0.442 in the ITT population; in the PSA > 20 ng/mL sub-group, the incremental cost was ¥7,165.07 and ¥20,180.88 with an incremental QALY of 0.475. The chance of being cost-effective was 82% (compared to goserelin) and 76% (compared to leuprorelin) in the ITT population and 91% (compared to goserelin) and 87% (compared to leuprorelin) in the PSA > 20 ng/mL sub-group at a threshold of ¥178,980 per QALY. Degarelix showed dominant in both population when Patient Assistance Program price and marked-down price were used. The model was most sensitive to the hazard ratio assumed for PSA progression between degarelix and LHRH agonists and utility of patient with palliative care in all scenarios.

CONCLUSIONS : Degarelix is likely to be cost-effective compared to goserelin and leuprorelin in the treatment of prostate cancer in China.