TY - JOUR
T1 - Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
AU - Aguiar, Pedro Nazareth
AU - Barreto, Carmélia Maria Noia
AU - Gutierres, Bárbara de Souza
AU - Tadokoro, Hakaru
AU - Lopes, Gilberto de Lima
PY - 2017/7/1
Y1 - 2017/7/1
N2 - OBJECTIVE: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer.METHODS: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated.RESULTS: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease.CONCLUSION: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.
AB - OBJECTIVE: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer.METHODS: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated.RESULTS: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease.CONCLUSION: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.
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U2 - 10.1590/S1679-45082017GS4017
DO - 10.1590/S1679-45082017GS4017
M3 - Article
C2 - 29091159
AN - SCOPUS:85038130119
SN - 1679-4508
VL - 15
SP - 349
EP - 354
JO - Einstein (Sao Paulo, Brazil)
JF - Einstein (Sao Paulo, Brazil)
IS - 3
ER -