Cost-Effectiveness Analysis of 12-Versus 4-Weekly Administration of Bone-Targeted Agents in Patients with Bone Metastases from Breast and Castration-Resistant Prostate Cancer
- Resource Type
- Authors
- Carol Stober; Mihaela Mates; Terry L. Ng; Olexiy Aseyev; Mark Clemons; Ahwon Jeong; Lisa Vandermeer; Kednapa Thavorn; Anil A. Joy; Gregory R. Pond; Dean Fergusson; Phillip S. Blanchette; Megan M. Tu
- Source
- Current Oncology, Vol 28, Iss 171, Pp 1847-1856 (2021)
Current Oncology
Volume 28
Issue 3
Pages 171-1856
- Subject
- Male
Oncology
Canada
medicine.medical_specialty
Cost effectiveness
Cost-Benefit Analysis
Bone Neoplasms
Article
03 medical and health sciences
Prostate cancer
breast cancer
0302 clinical medicine
Breast cancer
Internal medicine
medicine
Humans
030212 general & internal medicine
cost-effectiveness
RC254-282
bone metastasis
business.industry
zoledronate
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Bone metastasis
Cancer
denosumab
Cost-effectiveness analysis
prostate cancer
medicine.disease
Clinical trial
Prostatic Neoplasms, Castration-Resistant
pamidronate
Denosumab
030220 oncology & carcinogenesis
Quality-Adjusted Life Years
business
medicine.drug
- Language
- ISSN
- 1718-7729
A cost–utility analysis was performed based on the Rethinking Clinical Trials (REaCT) bone-targeted agents (BTA) clinical trial that compared 12-weekly (once every 12 weeks) (n = 130) versus 4-weekly (once every 4 weeks) (n = 133) BTA dosing for metastatic breast and castration-resistant prostate (CRPC) cancer. Using a decision tree model, we calculated treatment and symptomatic skeletal event (SSE) costs as well as quality-adjusted life-years (QALYs) for each treatment option. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the study findings. The total cost of BTA treatment in Canadian dollars (C$) and estimated QALYs was C$8965.03 and 0.605 QALY in the 4-weekly group versus C$5669.95 and 0.612 QALY in the 12-weekly group, respectively. De-escalation from 4-weekly to 12-weekly BTA reduces cost (C$3293.75) and improves QALYs by 0.008 unit, suggesting that 12-weekly BTA dominates 4-weekly BTA in breast and CRPC patients with bone metastases. Sensitivity analysis suggests high levels of uncertainty in the cost-effectiveness findings. De-escalation of bone-targeted agents is cost-effective from the Canadian public payer’s perspective.