ORLANDO, FL USA (UroToday.com) - The objective of this multi-institutional study was to determine the comparative effectiveness and cost-effectiveness of abiraterone acetate (AA) versus enzalutamide (ENZ). They used population, intervention, comparison, and outcomes (PICO) to evaluate the comparability of the pivotal phase 3 clinical trials: COU-AA-301 for AA and AFFIRM for ENZ. Bucher method and Bayesian statistics was used to conduct an indirect treatment comparison. A survival-based Markov cohort model with 3 health states (progression-free, progressed, and death) was developed to estimate cost-effectiveness over a lifetime horizon. For a 30-day supply of AA and ENZ, the average wholesale prices were $7674 and $8940, respectively. They utilized one-way sensitivity analyses for all probability, utility, and cost values incorporated into the model.
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After accounting for important differences in comparators and background treatments, the results of indirect treatment comparison showed no significant difference in overall survival for AA compared to ENZ. In the base case of the economic analysis, AA was found to provide an annual cost savings of $13,322 per patient and this is primarily due to higher acquisition costs of ENZ. Quality-adjusted life years gained were comparable for AA and ENZ. These results were supported by sensitivity analyses. AA and ENZ are 2 treatment options for patients with metastatic castration-resistant prostate cancer. Presently, there is great interest in understanding the relative clinical and economic value of these therapies. The results of this indirect treatment comparison shows that both AA and ENZ can have similar efficacy in terms of OS in post chemotherapy mCRPC patients; However, it appears that AA is more cost effective compared to ENZ.
Click HERE to view the poster from this session
Presented by Melissa Thompson at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Burlington, ON Canada
Written by Reza Mehrazin, MD, medical writer for UroToday.com