Is Olaparib Cost Effective in Metastatic Castration-Resistant Prostate Cancer Patients with at Least one Favorable Gene Mutation in
 BRCA1
 ,
 BRCA2
 or
 ATM
 ?

Li, Yiyuan; Shen, Lin; Zhong, Lixian; Luo, Shaohong; Huang, Xiaoting; Huang, Xiaojia; Dong, Liu; Xu, Xiaowu; Weng, Xiuhua

doi:10.2217/pgs-2021-0061

Cited by 8 publications

(26 citation statements)

References 25 publications

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“…PARPi evaluated in these studies included olaparib [ 16 – 18 , 20 – 22 , 25 – 28 , 30 – 32 , 34 – 40 ], niraparib [ 18 – 20 , 23 , 26 , 28 ], rucaparib [ 20 , 28 ], talazoparib [ 33 ], and veliparib [ 24 ]. Modeling methods employed included the Markov model (n = 11) [ 16 , 21 , 22 , 24 , 28 , 30 , 32 , 36 , 37 , 39 , 40 ], decision tree model (n = 6) [ 17 – 20 , 23 , 35 ], partitional survival model (n = 7) [ 25 , 27 , 31 , 33 , 34 , 38 ], and the non-Markov alternatives (n = 1) [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Ding

He²,

Tong³

et al. 2022

PLoS ONE

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Objectives Poly (ADP-ribose) polymerase inhibitor (PARPi) have become a mainstay for the treatment of BRCA-mutant malignancies. PARPis are likely to be more effective but also bring an increase in costs. Thus, we aimed at evaluating the cost effectiveness of PARPis in the treatment of malignancies. Methods Studies of cost effectiveness of PARPis were searched from PubMed, Web of Science, and Cochrane Library. Key information was extracted from the identified studies and reviewed. Quality of the included studies was evaluated using Quality of Health Economic Studies (QHES) instrument. Modeling techniques, measurement of parameters and uncertainty analysis were analyzed across studies. Interventions and cost-effectiveness results were reported stratified by patient population. Results Among the 25 studies identified, we included 17 on ovarian cancer, 2 on breast cancer, 3 on pancreatic cancer, and 3 on prostate cancer that involved olaparib, niraparib, rucaparib, and talazoparib. All studies had a QHES score of above 75. In the maintenance therapy of ovarian cancer, additional administration of olaparib was cost-effective for newly diagnosed patients after first-line platinum-based chemotherapy but was not cost-effective for platinum-sensitive recurrent patients in majority studies. However, the economic value of other PARPis in ovarian cancer as well as all PARPis in other tumors remained controversial. Cost-effectiveness of PARPi was primarily impacted by the costs of PARPi, survival time, health utility and discount rate. Moreover, genetic testing improved the cost-effectiveness of PARPi treatment. Conclusions PARPi is potentially cost-effective for patients with ovarian, pancreatic, or prostate cancer. Genetic testing can improve the cost-effectiveness of PARPi.

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Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Ding

He²,

Tong³

et al. 2022

PLoS ONE

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“…Therefore, evaluating the cost-utility scores of olaparib from the perspective of pharmacoeconomics is of great significance, though there are few studies on the cost-utility scores of olaparib in treating mCRPC. From the perspective of United States payers, Li et al ( 21 ) evaluated the cost-utility scores of olaparib in treating mCRPC patients with BRCA1, BRCA2, or ATM mutation, and the results showed that the cost and utility of olaparib treatment were $157,732 and 1.26 QALYs, respectively. Compared with the control group, the ICER of olaparib was $248,248/QALY.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of olaparib, a PARP inhibitor, for patients with metastatic castration-resistant prostate cancer in China and United States

Xu¹,

Cai²,

Zhuang³

et al. 2022

Ann Transl Med

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Background Metastatic prostate cancer is initially sensitive to androgen receptor inhibition, but eventually becomes metastatic castration-resistant prostate cancer (mCRPC). Olaparib has longer progression-free survival and better measures of response and patient-reported end points than either enzalutamide or abiraterone. In the present study, 2 Markov models were established to analyze the cost utility of olaparib in treating mCRPC from the perspectives of health services in China and the United States. Methods Markov models were established to simulate the progress of mCRPC in China and the United States. The state transition probabilities and clinical data were extracted from the PROfound trial. The cost data were estimated from local pricing, the relevant literature and expert consultancy. The health outcomes are expressed by quality-adjusted life years (QALYs). All costs and incremental cost-effectiveness ratios (ICERs) are presented in US dollars. One-way deterministic sensitivity analysis and probabilistic sensitivity analysis were performed to assess the uncertainty of the models. Results Based on the Chinese Markov model, the base case ICER for olaparib versus the control group was ¥392,727.87, with incremental costs of ¥93,673.23 and an incremental QALY of 0.23, indicating that it was not cost effective from the aspect of the Chinese healthcare system. However, as shown by the American Markov model, olaparib was dominant versus the control group, with a cost saving of $69,675.20 and a gain of 0.23 QALYs. One-way deterministic sensitivity analysis and probabilistic sensitivity analyses showed that the modeling results were not significantly affected by the model parameters. Conclusions Olaparib treatment in patients with mCRPC is not cost effective in China, but it is cost saving in the United States.

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“…43,44 The economics of adopting such an approach, however, is not clear. Our search strategy led us to two studies 19,24 on the cost-effectiveness of genetic test-directed treatment with the PARP inhibitor, Olaparib in men with mCRPC. However, the setting for both studies were men who tested positive for three or 15 pre-specified gene alterations i.e., both the intervention group (olaparib therapy) and the comparator (standard care) were men who were variant positive.…”

Section: Discussionmentioning

confidence: 99%

“…However, the setting for both studies were men who tested positive for three or 15 pre-specified gene alterations i.e., both the intervention group (olaparib therapy) and the comparator (standard care) were men who were variant positive. It was not possible to examine the cost-benefits of a germline testing versus no testing scenario and both studies 19,24 were excluded from the review. Overall, the evidence on cost-effectiveness of germline testing in prostate cancer is limited, therefore policy advice for testing in this cancer group is not yet possible.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several additional studies on the cost-effectiveness of germline testing since the previous reviews. [16][17][18][19][20][21][22][23][24][25][26] Some of them assessed population-wide testing, 17,20 while others, evaluated the cost-utility of A c c e p t e d M a n u s c r i p t germline testing guided treatments in cancer patients with mutations. 26 Next-generation sequencing (NGS) has also become affordable.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A review of the cost-effectiveness of genetic testing for germline variants in familial cancer

Teppala

Hodgkinson

Hayes

et al. 2022

Journal of Medical Economics

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Author contributionsST performed the literature search, data abstraction and synthesis, quality assessment and prepared the first draft of the manuscript. HT, PS and SH contributed to the conceptual design of the study and towards revisions to the manuscript. BH reviewed the literature search, methodology, quality assessment and provided feedback for revisions. All the authors read and agreed to the final version of the article.

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Is Olaparib Cost Effective in Metastatic Castration-Resistant Prostate Cancer Patients with at Least one Favorable Gene Mutation in BRCA1 , BRCA2 or ATM ?

Cited by 8 publications

References 25 publications

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Cost-effectiveness of olaparib, a PARP inhibitor, for patients with metastatic castration-resistant prostate cancer in China and United States

A review of the cost-effectiveness of genetic testing for germline variants in familial cancer

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