PMID- 33634066
OWN - NLM
STAT- MEDLINE
DCOM- 20210527
LR  - 20210527
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 9
DP  - 2021
TI  - Adding Enzalutamide to First-Line Treatment for Metastatic Hormone-Sensitive 
      Prostate Cancer: A Cost-Effectiveness Analysis.
PG  - 608375
LID - 10.3389/fpubh.2021.608375 [doi]
LID - 608375
AB  - Background: The aim of this study is to evaluate the pharmacoeconomic profile of 
      adding enzalutamide to first-line treatment for metastatic, hormone-sensitive 
      prostate cancer (mHSPC) from the US and Chinese payers' perspectives. Materials 
      and Methods: A Markov model with three health states: progression-free survival 
      (PFS), progressive disease (PD), and death, was constructed. All patients were 
      assumed to enter the model in the PFS state and transit according to the 
      transition structure. Efficacy data were derived from the ENZAMET trial and 
      Weibull distribution curves were modeled to fit the survival curves. Costs in the 
      model included cost of drugs, best-supportive care (BSC), follow-up, tests, and 
      adverse events (AEs)-related treatments. The primary endpoint of the study was 
      incremental cost-effectiveness ratio (ICER). In addition, the impact of several 
      key parameters on the results of the cost-effectiveness analysis was tested with 
      one-way sensitivity analyses and probabilistic sensitivity analyses. Results: 
      Overall, ICERs were $430,933.95/QALY and $225,444.74/QALY of addition of 
      enzalutamide to androgen deprivation therapy (ADT) vs. ADT from the US and 
      Chinese payers' perspective, respectively. The most influential factors were the 
      utility for the PFS state and the cost of enzalutamide. At the willingness-to-pay 
      (WTP) thresholds of $100,000.00/QALY in the US and $28,988.40/QALY in China, the 
      probability of adding enzalutamide to first-line treatment being a cost-effective 
      option for mHSPC was 0%. Conclusions: Based on the data from the ENZAMET trial 
      and the current price of enzalutamide, adding enzalutamide to first-line 
      treatment is not cost-effective for patients with mHSPC from the US and Chinse 
      payers' perspectives.
CI  - Copyright (c) 2021 Zhang, Xie and Li.
FAU - Zhang, Peng-Fei
AU  - Zhang PF
AD  - Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu, China.
AD  - West China Biomedical Big Data Center, West China Hospital/West China School of 
      Medicine, Sichuan University, Chengdu, China.
FAU - Xie, Dan
AU  - Xie D
AD  - Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, West China 
      Second University Hospital, Sichuan University, Chengdu, China.
AD  - Key Laboratory of Birth Defects and Related Diseases of Women and Children 
      (Sichuan University), Ministry of Education, Chengdu, China.
FAU - Li, Qiu
AU  - Li Q
AD  - Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu, China.
AD  - West China Biomedical Big Data Center, West China Hospital/West China School of 
      Medicine, Sichuan University, Chengdu, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210209
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
RN  - 0 (Androgen Antagonists)
RN  - 0 (Benzamides)
RN  - 0 (Hormones)
RN  - 0 (Nitriles)
RN  - 2010-15-3 (Phenylthiohydantoin)
RN  - 93T0T9GKNU (enzalutamide)
SB  - IM
MH  - *Androgen Antagonists
MH  - Benzamides
MH  - China/epidemiology
MH  - Cost-Benefit Analysis
MH  - Hormones
MH  - Humans
MH  - Male
MH  - Nitriles
MH  - Phenylthiohydantoin
MH  - *Prostatic Neoplasms/drug therapy
MH  - Quality-Adjusted Life Years
PMC - PMC7902073
OTO - NOTNLM
OT  - androgen deprivation therapy
OT  - cost-effectiveness
OT  - enzalutamide
OT  - first-line
OT  - prostate cancer
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/02/27 06:00
MHDA- 2021/05/28 06:00
PMCR- 2021/02/09
CRDT- 2021/02/26 06:04
PHST- 2020/10/10 00:00 [received]
PHST- 2021/01/19 00:00 [accepted]
PHST- 2021/02/26 06:04 [entrez]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2021/05/28 06:00 [medline]
PHST- 2021/02/09 00:00 [pmc-release]
AID - 10.3389/fpubh.2021.608375 [doi]
PST - epublish
SO  - Front Public Health. 2021 Feb 9;9:608375. doi: 10.3389/fpubh.2021.608375. 
      eCollection 2021.