PMID- 25313181
OWN - NLM
STAT- MEDLINE
DCOM- 20151009
LR  - 20190918
IS  - 1540-1413 (Electronic)
IS  - 1540-1405 (Linking)
VI  - 12
IP  - 10
DP  - 2014 Oct
TI  - Cost-effectiveness analysis of abiraterone and sipuleucel-T in asymptomatic 
      metastatic castration-resistant prostate cancer.
PG  - 1417-25
AB  - Of patients diagnosed with prostate cancer, 0% to 20% experience disease 
      progression to metastatic castration-resistant prostate cancer (mCRPC). Recently, 
      4 novel therapies have been introduced for the treatment of mCRPC; of these, 
      abiraterone and sipuleucel-T have been studied in the asymptomatic, pre-docetaxel 
      population. Both have shown clinical benefits compared with placebo. This study 
      evaluated the cost-effectiveness of abiraterone acetate and sipuleucel-T compared 
      with prednisone in asymptomatic, pre-docetaxel mCRPC from a US societal 
      perspective. A Markov model was constructed to simulate stable disease, 
      progressed disease, and death. Survival and event rates were derived from 
      published clinical trial data. Costs were derived from the literature and 
      government reimbursement schedules. Outcomes were measured as average 
      cost-effectiveness ratios (ACERs), incremental cost-effectiveness ratios (ICERs), 
      and net monetary benefits (NMBs). One-way and probabilistic sensitivity analyses 
      were conducted to test the robustness of the model. The base-case ACER was 
      $114K/quality-adjusted life-years (QALY) for abiraterone, $85K/QALY for 
      sipuleucel-T, and $31K/QALY for prednisone. The base-case ICER was $389K/QALY for 
      abiraterone and $547K/QALY for sipuleucel-T. Prednisone dominates both 
      abiraterone and sipuleucel-T in terms of NMB at willingness-to-pay (WTP) 
      thresholds of $400K or less. One-way sensitivity analyses revealed that the model 
      was most sensitive to overall survival and utility inputs. Probabilistic 
      sensitivity analyses showed abiraterone to be cost-effective 50% or more of the 
      time at a WTP of greater than $400K, whereas sipuleucel-T was cost-effective 50% 
      or more of the time at a WTP of greater than $270K. Neither abiraterone nor 
      sipuleucel-T was found to be cost-effective compared with prednisone in the 
      treatment of asymptomatic, pre-docetaxel mCRPC.
CI  - Copyright (c) 2014 by the National Comprehensive Cancer Network.
FAU - Gong, Cynthia L
AU  - Gong CL
AD  - From Schaeffer Center for Health Policy & Economics, University of Southern 
      California, Los Angeles, California.
FAU - Hay, Joel W
AU  - Hay JW
AD  - From Schaeffer Center for Health Policy & Economics, University of Southern 
      California, Los Angeles, California.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Natl Compr Canc Netw
JT  - Journal of the National Comprehensive Cancer Network : JNCCN
JID - 101162515
RN  - 0 (Androstenes)
RN  - 0 (Tissue Extracts)
RN  - 8Q622VDR18 (sipuleucel-T)
RN  - G819A456D0 (abiraterone)
SB  - IM
MH  - Androstenes/economics/*therapeutic use
MH  - Asymptomatic Diseases
MH  - Bone Neoplasms/*drug therapy/economics/mortality/secondary
MH  - Cost-Benefit Analysis
MH  - Disease-Free Survival
MH  - Humans
MH  - Male
MH  - Prostatic Neoplasms, Castration-Resistant/*drug 
      therapy/economics/mortality/pathology
MH  - Quality of Life
MH  - Tissue Extracts/economics/*therapeutic use
EDAT- 2014/10/15 06:00
MHDA- 2015/10/10 06:00
CRDT- 2014/10/15 06:00
PHST- 2014/10/15 06:00 [entrez]
PHST- 2014/10/15 06:00 [pubmed]
PHST- 2015/10/10 06:00 [medline]
AID - 12/10/1417 [pii]
AID - 10.6004/jnccn.2014.0139 [doi]
PST - ppublish
SO  - J Natl Compr Canc Netw. 2014 Oct;12(10):1417-25. doi: 10.6004/jnccn.2014.0139.