title: Cost-effectiveness analysis of additional docetaxel for metastatic hormone-sensitive prostate cancer treated with androgen-deprivation therapy from a Chinese perspective.
abstract: The E3805 (CHAARTED) study found that docetaxel combined with androgen-deprivation therapy (ADT) significantly improved overall survival of patients with metastatic hormone-sensitive prostate cancer. This study aims to determine whether docetaxel combined with ADT is a cost-effective strategy for advanced prostate cancer in China. According to the E3805 study, two groups (docetaxel + ADT and ADT alone) and three health states [progression-free survival (PFS), progressive disease (PD) and death] were analysed in a Markov model. All medical costs were calculated from the Chinese societal perspective. Quality-adjusted life year (QALY) and incremental cost-effectiveness ratios (ICERs) were applied as the primary outcome. Overall, the addition of docetaxel was estimated to increase the cost by $12 816.93, with a gain of 0.48 QALY. Additionally, for patients with high-volume disease, the increased cost and effectiveness were $14 627.75 and 0.69 QALYs in docetaxel + ADT group versus the ADT alone group, and the ICER was $21 199.63 per QALY. These ICERs are far more than the commonly accepted willingness-to-pay (WTP) threshold of $20 301 per QALY in China. In spite of longer survival time, docetaxel combined with ADT is not a recommended cost-effective treatment for metastatic hormone-sensitive prostate cancer in the Chinese setting.
authors.affiliation: Department of Clinical Pharmacy, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: H R
authors.initials: HR
authors.lastname: Zheng
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: F
authors.initials: F
authors.lastname: Wen
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Y F
authors.initials: YF
authors.lastname: Wu
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor, MI, USA.
authors.forename: J R C
authors.initials: JRC
authors.lastname: Wheeler
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000191:economics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D002681:China; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D016527:Drug Costs; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D019057:Quality-Adjusted Life Years; D043823:Taxoids / Q000008:administration & dosage / Q000191:economics; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D043823:Taxoids; D000077143:Docetaxel; D003907:Dexamethasone
keywords: androgen-deprivation therapy; cost-effectiveness; docetaxel; prostate cancer