Application of a novel method weighing drug costs against survival in castrate-resistant prostate cancer cancer.

Authors

null

Helmy M. Guirgis

University of California, Irvine, Irvine, CA

Organizations

University of California, Irvine, Irvine, CA

Research Funding

No funding sources reported

Background: In the last few years, 5 new anticancer drugs have been introduced for the treatment of castration-resistant prostate cancer (CRPC). The objective was to apply a simplified methodology of weighing drug costs against overall survival (OS) in CRPC. Methods: Estimated cost in United Sates (US) dollars of an entire treatment course of an evaluated drug was divided by previously reported median OS gain over control. An initial survey of 45 drugs demonstrated that the maximal cost/OS/day gain was $757. Accordingly, a scale of crude scores was constructed with a 0% assigned to a cost/OS gain greater than $1,000 and 100% to a cost/OS gain of $1. Value scores were calculated after adjusting for quality of life (QoL), adverse events (AEs), and specialized administration and preparation (AP). Results: The lowest cost/OS gain and highest value score were demonstrated by generic docetaxel. Enzalutamide in previously-treated and abiraterone in chemo-naïve and treated patients x 6 months showed cost/OS gain lower than that of docetaxel but significantly higher than cabazitaxel. Pricing of sipuleucel-T based on cost of the entire course partly accounted for its highest cost/OS and lowest scores. Extending abiraterone and enzalutamide treatment to 12 months increased cost/OS gain and decreased scores. Conclusions: Methodology was proposed to weigh drug cost against OS/day gain with and without adjustment for QoL, AEs, and AP. Results in CRPC tend to support use of docetaxel, abiraterone, and enzalutamide rather than cabazitaxel and sipuleucel-T. Varying drug indications and different populations within the CRPC spectrum preclude direct drug comparison.

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Abstract Details

Meeting

2013 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B: Practice of Quality and Health Reform

Track

Practice of Quality,Health Reform: Implications for Costs and Quality

Sub Track

Measuring Value and Costs

Citation

J Clin Oncol 31, 2013 (suppl 31; abstr 271)

Abstract #

271

Poster Bd #

G6

Abstract Disclosures