OBJECTIVES:

Poly ADP ribose polymerase (PARP) inhibitors are a new class of drugs to treat recurrent ovarian cancer (ROC) associated with BRCA1 and BRCA2 gene mutation. Since the PARB enzyme inhibitors, Olaparib and Niraparib are relatively new to the market, there is limited research investigating these drugs' cost-effectiveness (CE). This study aimed to evaluate the CE of Olaparib compared to niraparib in treating ROC from a US healthcare perspective.

METHODS:

A Markov model was developed to estimate the incremental cost-effectiveness ratio (ICER) of niraparib compared to Olaparib in treating recurrent ovarian cancer. The Markov model consisted of two health states, including the progression-free survival (PFS) and the progressed disease (PD). The patient could transition from the PFS to PD to mimic the natural progression of the disease.

RESULTS:

The incremental cost-effectiveness ratio (ICER) of Olaparib compared to Niraparib was estimated to be $159,323 per PFSY. The result of probabilistic sensitivity analysis using Monte Carlo simulations under 1000 iterations suggests that Olaparib is considered more cost-effective until a willingness-to-pay (WTP) of $160,000. Under a WTP of $100,000, Olaparib was 65% likely to be cost-effective when compared with Niraparib. The one-way sensitivity analysis suggests that amongst all the variables, the most critical drivers for the model were the cost of Olaparib and niraparib per year and the health utility values for PFS. The direction of the base-case results was consistent in terms of costs and utility.

CONCLUSIONS:

We found that Olaparib was cost-effective compared to Niraparib under a WTP of $100,000. The price for Niraparib is suggestive to be reduced to make it a better candidate than Olaparib.