Author(s)
Holleman MS1, Santi I2, Huygens S3, Aben KKH4, Van den Bergh ACM5, Bergman AM6, van den Eertwegh AJM7, Kuppen MCP8, Lavalaye J9, Mehra NM10, van Moorselaar RJA11, Van Oort IM10, Somford DM12, Westgeest HM8, Gerritsen WR10, Uyl-De Groot C13
1institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, Netherlands, 2institute for Medical Technology Assessment, Rotterdam, Netherlands, 3institute for Medical Technology Assessment, Rotterdam, ZH, Netherlands, 4Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands, 5University Medical Center Groningen, Groningen, Netherlands, 6Netherlands Cancer Institue, Amsterdam, Netherlands, 7Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, Netherlands, 8Amphia Hospital, Breda, Netherlands, 9Sint Antonius Ziekenhuis, Nieuwegein, Netherlands, 10Radboud University Medical Center, Nijmegen, Netherlands, 11Amsterdam University Medical Center, Amsterdam, Netherlands, 12Canisius Wilhelmina Hospital, Nijmegen, Netherlands, 13Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands
OBJECTIVES First-line treatment options for castration-resistant prostate cancer (CRPC) include both docetaxel (DOC; available in the Netherlands since 2004) or abiraterone acetate plus prednisone (ABI; available in the Netherlands for chemotherapy-naïve since 2013). Overall survival (OS) of DOC or ABI do not significantly differ in indirect comparisons, while there is a difference in drug costs. Consequently, treatment costs might be considered when selecting a first-line treatment. This study aimed to evaluate costs and survival of the whole treatment pathway of real-world CRPC-patients that received either first-line DOC or ABI using propensity score matching (PSM). METHODS Data were obtained from the CAstration-resistant PRostate cancer RegIstry (CAPRI), which is an observational multi-centre registry conducted in the Netherlands. Patients who received first-line DOC or ABI between 2010 and 2015 were matched using PSM with a greedy matching algorithm and a 1:1 ratio based on baseline demographic and clinical characteristics. OS was evaluated using the Kaplan-Meier method and Cox regression. All drug, hospital and travel costs of CRPC patients were estimated. RESULTS In each treatment group, 331 patients were matched by PSM. No significant differences in OS were found between patients treated with first-line DOC or ABI followed by other treatments (median: 31.3 vs 34.3 months; HR: 1.05; 95%CI 0.87-1.27; P-value=0.588). Patients treated with first-line ABI had less subsequent treatments (44%) compared to patients treated with first-line DOC (78%). Mean total lifetime costs were €58,123 for the treatment sequences starting with DOC (drug acquisition costs: €29,434; other costs: €28,689). For the treatment sequences starting with ABI, mean total lifetime costs were €58,887 (drug acquisition costs: €38,994; other costs: €19,893). CONCLUSIONS : No significant differences in OS and healthcare costs were found between patients treated with DOC or ABI in first-line. Therefore, factors like patient preferences, adverse events and quality of life should also be considered when choosing a treatment.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSC399
Topic
Clinical Outcomes, Economic Evaluation
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Drugs, Oncology
