NEW ORLEANS, LA USA (UroToday.com) - Prostate cancer is the second leading cause of cancer death and has a significant economic burden. Enzalutamide was approved by the FDA for an expanded indication based on improvement in overall survival and radiographic progression-free survival in chemotherapy-naïve metastatic castrate-resistant prostate cancer (mCRPC) patients. The group’s objective was to estimate budget impact (BI) of adopting enzalutamide, per patient per year (PPPY) cost impact, and per member per month (PMPM) cost impact.
SEER’s incidence rates were used to estimate total number of chemotherapy-naïve mCRPC patients in a hypothetical 1-million member US health plan. Treatments included abiraterone, sipuleucel-T, radium-223, and docetaxel. Dosing, administration, mean duration of therapy and adverse (AE) rates were based on package inserts as well as initial pivotal studies. Costs of drugs were obtained from RedBook and CMS ASP pricing files, administration and monitoring from CMS Physician Fee Schedule, and AEs from AHRQ H-CUP and published literature.
In an estimated population of 115 mCRPC patients, adopting enzalutamide had a modest annual plan impact--$510 641 budget impact, $4 426 PPPY, and $0.04 PMPM. Enzalutamide costs were offset by moderate AEs and no additional monitoring costs.
The group concludes that a modest one-year BI exists in adoption of enzalutamide for chemotherapy-naïve mCRPC. Further analysis to understand cost per clinical outcome may complement the BI model and help us understand the relative costs and benefits of using enzalutamide.
Presented by Ken O'Day at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Palm Harbor, FL USA
Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com