Economic evaluation of different hormonal therapies for prostate cancer. Final results from the Quality of Life Antiandrogen Blockade Italian Observational Study (QuABIOS).
OBJECTIVE
The paper compares costs and Quality-Adjusted Life Years (QALYs) of different hormonal therapies (HTs) administered to 275 out of 471 patients with prostate cancer (PC) enrolled in the Quality of Life Antiandrogen Blockade Italian Observational Study (QuABIOS), who did not change HT during the study period.


METHODS
QALYs and costs related to monoHT witk cyproterone acetate (CYP) (42 patients); bicalutamide (BIC) (41 patients); LHRH-a (96 patients) and complete androgenic blockade (CAB) with: CYP (CYP CAB) (50 patients); BIC (BIC CAB) (46 patients) were compared via a cost-utility analysis (CUA) adopting the Italian National Healthcare Service (INHS) viewpoint.


RESULTS
As no statistical significant difference among the mean QALYs gained with the different HTs was detected (p = 0.116), CUA was replaced by a cost minimization analysis (CMA). However, the lowest and the highest mean QALYs gained per patient were registered for BIC CAB (0.59; 95% CI: 0.50; 0.68) and for for CYP (0.75; 95% CI: 0.68; 0.82), respectively. CYP was the least costly HT, reaching the lowest and the highest savings when compared to LHRH-a (-Euros 974.99; 95% CI: -Euros 1066.86; -Euros 883.12; p<0.0001) and to monoHT with BIC (-Euros 5887.81; 95% CI: -Euros 6143.99; -Euros 5631.64; p<0.0001). A nonparametric bootstrap sensitivity analysis confirmed the robustness of the base case CMA.


CONCLUSIONS
CYP is an interesting option for curbing the INHS drug expenditure for PC patients, with a trend towards increasing the mean number of QALYs gained.
Lazzaro
Carlo
C
A.-O.SM. Annunziata, Univ. Firenze, Italy. carlo.lazzaro@tin.it
Bartoletti
Riccardo
R
Guazzoni
Giorgio
G
Orestano
Fausto
F
Pappagallo
Giovanni L
GL
Prezioso
Domenico
D
Zattoni
Filiberto
F
D000726:Androgen Antagonists / Q000191:economics* / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000191:economics*; D011788:Quality of Life
D000726:Androgen Antagonists