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OBJECTIVE: To evaluate the cost-effectiveness of the addition of chemotherapy or abiraterone to androgen deprivation. METHODS: We developed an analytical model to determine the cost-effectiveness of the addition of docetaxel or abiraterone versus androgen deprivation therapy alone. Direct and indirect costs were included in the model. The effects were expressed in Quality-Adjusted Life Years adjusted for side effects. RESULTS: Compared to androgen deprivation therapy alone, the addition of chemotherapy and of abiraterone generated 0.492 and 0.999, respectively, in Quality-Adjusted Life Years. Abiraterone led to a Quality-Adjusted Life Years gain of 0.506 compared to docetaxel. The incremental costs per Quality-Adjusted Life Years were R$ 133.649,22 for docetaxel, R$ 330.828,70 for abiraterone and R$ 571.379,42 for abiraterone compared to docetaxel, respectively. CONCLUSION: The addition of chemotherapy to androgen deprivation therapy is more cost-effective than the addition of abiraterone to androgen deprivation therapy. However, discounts on abiraterone cost might improve cost-effectiveness.

Original publication

DOI

10.31744/einstein_journal/2019GS4414

Type

Journal article

Journal

Einstein (Sao Paulo)

Publication Date

07/03/2019

Volume

17

Keywords

Androgen Antagonists, Androstenes, Antineoplastic Agents, Hormonal, Antineoplastic Combined Chemotherapy Protocols, Brazil, Cost-Benefit Analysis, Docetaxel, Humans, Male, Placebos, Progression-Free Survival, Prostatic Neoplasms, Quality-Adjusted Life Years, Reference Values, Reproducibility of Results, Time Factors, Treatment Outcome