OBJECTIVES

To estímate costs for metastatic castration-resistant prostate cancer (mRCC) in order to assess the relative value of abiraterone plus prednisone (AAP )and enzalutamide (ENZ) for mCRPC patients.

METHODS

A retrospective/prospective cohort study using data from EVIREPRO data bases (Real life study of insured cancer pts sponsored by Investigar Foundation)) and treatment costs were obtained from INSSJP formulary (veterans HMO) . Males ≥18 years with ≥1 year follow up for prostate cancer diagnosis and no end stage renal disease and/or other primary cancer diagnosis were selected according the first observed mCRPC-specific treatment date between 8/25/2015-8/25/2018. Patient characteristics during ≥6 months prior were described; 12-month all-cause costs in 2018 US dollars were estimated. Generalized linear model was used to compare adjusted cost between AAP and ENZ cohorts.

RESULTS

Of a total of 651 patients (pts.), 222 were mCRPC pts. from the EVIREPRO databases and were followed up for a mean of 478 days. Among insured mCRPC pts, 133/222 received treatment for at least 1 year., mean age was 69.7 (SD=4.2) years). All-cause 12-month costs were $7.680.707 USD (mCRPC treatment): medical care: USD 18.260, other pharmacy: USD 12,449. Among 85 AAP and 68 ENZ insured patients, adjusted 12-month costs were $3.133.752 vs $4.514.688 (p<.0001).

CONCLUSIONS

Costs among mCRPC patients show significant variation, with patients initiating on AAP incurring in significantly lower costs compared to ENZ over the first 12-months of treatment. Lower total costs for AAP patients resulted mainly from lower outpatient pharmacy costs and 11 comercialized competitor generics with lower prices