Abstract
The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC)
has been significantly modified by the availability of innovative but expensive treatments,
increasing the economic burden of prostate cancer. Here, we aimed to systematically
identify and review published economic evaluations (EEs) related to the treatment
of mHSPC and assess their quality. A systematic search was performed of the PubMed
and Cochrane databases. Three reviewers independently selected EEs by defined inclusion
and exclusion criteria. They extracted all data from each EE (general information,
study population, data about the EE, interventions and comparators, and outcomes).
They also assessed the quality of the selected EEs according to Drummond's checklist.
Fourteen EEs published between 2016 and 2021 were eligible for the systematic review.
The EEs found ADT + docetaxel to be the most cost-effective of all available treatments
as a first-line strategy for mHSPC (abiraterone acetate plus prednisone, enzalutamide,
and apalutamide). Five EEs showed that a simple price reduction of abiraterone acetate
of 50% to 75% could change the results to render this treatment also cost-effective
relative to that with docetaxel. Twelve EEs were of high quality, with a Drummond
score ≥ 7. Analysis of the 14 EEs identified by our systematic review, amongst which
78.6% met high quality standards, showed that ADT + docetaxel tends to be the most
cost-effective alternative for mHSPC. These results were assessed by sensitivity analysis.
The data provided by this systematic review help to provide a better understanding
of these treatments and the better use of healthcare resources.
Keywords
Abbreviations:
EE (economic evaluation), mHSPC (metastatic hormone-sensitive prostate cancer), ADT (androgen deprivation therapy), AA (abiraterone acetate plus prednisone), mCRPC (metastatic castration-resistant prostate cancer), ICUR (incremental cost-utility ratio), CUA (cost-utility analysis), WTP (willingness-to-pay), QALY (quality-adjusted life year), LY (life year), CEA (cost-effectiveness analysis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 28, 2022
Accepted:
April 23,
2022
Received:
December 8,
2021
Identification
Copyright
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