Analogues of LHRH versus orchidectomy: comparison of economic costs for castration in advanced prostate cancer

Rutqvist, Lars‐Erik; Wilking, Nils

doi:10.1038/bjc.1992.194

Cited by 10 publications

(2 citation statements)

References 6 publications

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“…In addition, the cost advantage of orchiectomy versus hormonal treatment may not be evident in all patients when considering the length of hospitalization following surgery and the duration of hormonal treatment being critical in economic evaluation 54. In Sweden, orchiectomy and hormonal treatments were found to be equivalent at 8 days of hospitalization and 18 months of hormonal treatment 55. Another economic analysis demonstrated that in the United States, orchiectomy was likely the most cost effective, while combined androgen blockade was the least cost effective treatment option, although leuprolide was not among the comparators 56.…”

Section: Discussionmentioning

confidence: 99%

Leuprolide acetate 1-, 3- and 6-monthly depot formulations in androgen deprivation therapy for prostate cancer in nine European countries: evidence review and economic evaluation

Wex¹,

Sidhu²,

Odeyemi³

et al. 2013

CEOR

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ObjectiveLeuprolide is an established luteinizing hormone–releasing hormone (LHRH) agonist used as first-line treatment in advanced prostate cancer. As different formulations and dosing schedules are likely to have economic implications, we aimed to evaluate their efficacy, safety, and costs in nine European countries: Austria, Belgium, Czech Republic, Hungary, Italy, Latvia, Netherlands, Poland, and Portugal.MethodsDatabase searches identified 13 clinical trials of leuprolide 1- (1 M), 3- (3 M) and 6-monthly (6 M). Only data on leuprolide with Atrigel were compared for all three formulations, which had the same efficacy, safety, and adherence. Cost-minimization analysis accounting for cost of Eligard®, specialist consultations, and diagnostics during up to 12 months follow-up was conducted. The perspective was that of public payers.ResultsNo significant differences were observed in the percentages of intention-to-treat patients achieving testosterone levels ≤ 50 ng/dL following treatment with Eligard® 1 M (93.3%), 3 M (98.3%), and 6 M (97.3%) (P > 0.05), and adverse event profiles of the three formulations were comparable. Overall, 6 M was the least expensive, with average total annual costs from €788 (Belgium) to €1839 (Portugal). The 3 M option was between 2.5% (Hungary) and 37.6% (Belgium) more expensive than 6 M; 1 M formulation was the most expensive, with costs 15.5% and 151.6% more expensive than 6 M for those countries, respectively. The 3 M option was 11.2%–45.3% less expensive than 1 M. Total costs were associated with frequency of visits for injection and monitoring. The 1 M required twelve visits, 3 M 4.4–4.8 visits, and 6 M 2.1–2.3 visits. Up to 50% additional visits could be funded with the savings resulting from switching eligible patients from 1 M and 3 M to 6 M. Results were stable in univariate and probabilistic sensitivity analyses.ConclusionEligard® formulations offer comparable efficacy and safety, but different dosing schedules require different number of visits. The 6 M formulation offers the greatest cost savings and should be considered the treatment of choice in eligible patients in Europe.

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Section: Discussionmentioning

confidence: 99%

Leuprolide acetate 1-, 3- and 6-monthly depot formulations in androgen deprivation therapy for prostate cancer in nine European countries: evidence review and economic evaluation

Wex¹,

Sidhu²,

Odeyemi³

et al. 2013

CEOR

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show abstract

“…Apart from orchiectomy, medical castration has become more and more estab lished and LHRH analogues in particular are of major importance. It is widely accepted that LHRH analogues have an efficacy equivalent to that of orchiectomy [10][11][12], Today, the 1-month depot formulations of LHRH ana logues are well established as standard therapeutic regi mens for the treatment of advanced prostate cancer [13][14][15][16][17][18][19]. The 1-month depot formulation of leuprorelin ace tate was further developed and a 3-month sustained release formulation produced [20,21] -it was believed that the 3-month depot would increase the patient's com pliance and provide a more convenient method of admin istration in long-term treatment [21], The 3-month depot was supplied as a lyophilized powder, consisting of micro spheres of leuprorelin acetate incorporated in a biode gradable polylactic-acid copolymer, in vials of 11.25 mg.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study Results of the New Formulation Leuprorelin Acetate Three-Month Depot for the Treatment of Advanced Prostate Carcinoma

Fornara¹,

Jocham²

1996

Urol Int

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Androgen suppression, using gonadotrophin-releasing hormone analogues (leuprorelin), is being developed as an effective treatment of advanced prostate carcinoma. Treatment with leuprorelin acetate 1-month depot is already well established all over the world. In order to increase patients’ acceptability of this treatment, by reducing frequency of administration, a 3-month depot formulation has been developed in Takeda’s research laboratories. A single-shot pharmacokinetic study was conducted to confirm efficacy in terms of hormone suppression and safety of the 3-month depot formulation. Thereafter, a parallel-group, open-labelled, randomized trial was performed to compare clinical efficacy and safety profiles of the 1- and 3-month depot formulations. Patients with a histologically and/or cytologically confirmed advanced prostate carcinoma, without prior hormonal or surgical androgen deprivation, are included. According to 1:2 randomization, patients are treated with either the 1- or 3-month depot for 9 months. To prevent initial flare-up, a concomitant antiandrogen therapy might be administered within 2 weeks prior to first injection and continued for up to 3 weeks. The clinical efficacy of the formulations is assessed by both objective response, EORTC and NPCTG response criteria, and subjective response by using WHO performance status. In addition, the level of prostate-specific antigen is determined every 3 months. The efficacy of the two formulations is also evaluated by determination of serum testosterone, dihydrotestosterone, luteinizing hormone and follicle stimulating hormone. To date, 106 patients have been treated with the 3-month depot and 53 patients with the 1-month depot. Preliminary evaluation shows a satisfying level of testosterone suppression with both the 3- and 1-month depot formulations. Therapeutic equivalence was assumed. The 3-month depot is tolerated as well as the 1-month depot.

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The Endocrinology of Prostate Cancer

Wasan¹,

Waxman²

1994

Tumours in Urology

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Analogues of LHRH versus orchidectomy: comparison of economic costs for castration in advanced prostate cancer

Cited by 10 publications

References 6 publications

Leuprolide acetate 1-, 3- and 6-monthly depot formulations in androgen deprivation therapy for prostate cancer in nine European countries: evidence review and economic evaluation

Leuprolide acetate 1-, 3- and 6-monthly depot formulations in androgen deprivation therapy for prostate cancer in nine European countries: evidence review and economic evaluation

Clinical Study Results of the New Formulation Leuprorelin Acetate Three-Month Depot for the Treatment of Advanced Prostate Carcinoma

The Endocrinology of Prostate Cancer

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