Cargando…
Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone
INTRODUCTION: Prostate cancer (PC) is the second leading cause of cancer death among US men and accounts for considerable healthcare expenditures. We evaluated economic outcomes in men with chemotherapy-naïve metastatic castration-resistant PC (mCRPC) treated with enzalutamide or abiraterone acetate...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467473/ https://www.ncbi.nlm.nih.gov/pubmed/32112280 http://dx.doi.org/10.1007/s12325-020-01260-x |
_version_ | 1783578021040488448 |
---|---|
author | Ramaswamy, Krishnan Lechpammer, Stanislav Mardekian, Jack Huang, Ahong Schultz, Neil M. Sandin, Rickard Wang, Li Baser, Onur George, Daniel J. |
author_facet | Ramaswamy, Krishnan Lechpammer, Stanislav Mardekian, Jack Huang, Ahong Schultz, Neil M. Sandin, Rickard Wang, Li Baser, Onur George, Daniel J. |
author_sort | Ramaswamy, Krishnan |
collection | PubMed |
description | INTRODUCTION: Prostate cancer (PC) is the second leading cause of cancer death among US men and accounts for considerable healthcare expenditures. We evaluated economic outcomes in men with chemotherapy-naïve metastatic castration-resistant PC (mCRPC) treated with enzalutamide or abiraterone acetate plus prednisone (abiraterone). METHODS: We performed a retrospective analysis on 3174 men (18 years or older) utilizing the Veterans Health Administration (VHA) database from 1 April 2014 to 31 March 2018. Men with mCRPC were included if they had at least one pharmacy claim for enzalutamide or abiraterone (first claim date = index date) following surgical or medical castration, had no chemotherapy treatment within 12 months prior to the index date, and had continuous VHA enrollment for at least 12 months pre- and post-index date. Men were followed until death, disenrollment, or end of study and were 1:1 propensity score matched (PSM). All-cause and PC-related resource use and costs per patient per month (PPPM) in the 12 months post index were compared between matched cohorts. RESULTS: We identified 1229 men with mCRPC prescribed enzalutamide and 1945 prescribed abiraterone with mean ages of 74 and 73 years, respectively. After PSM, each cohort had 1160 patients. The enzalutamide cohort had fewer all-cause (2.51 vs 2.86; p < 0.0001) and PC-related outpatient visits (0.86 vs 1.03; p < 0.0001), with corresponding lower all-cause ($2588 vs $3115; p < 0.0001) and PC-related ($1356 vs $1775; p < 0.0001) PPPM outpatient costs compared with the abiraterone cohort. All-cause total costs (medical and pharmacy) PPPM ($8085 vs $9092; p = 0.0002) and PC-related total costs PPPM ($6321 vs $7280; p < 0.0001) were significantly lower in the enzalutamide cohort compared with the abiraterone cohort. CONCLUSIONS: Enzalutamide-treated men with chemotherapy-naïve mCRPC had significantly lower resource utilization and healthcare costs compared with abiraterone-treated men. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-020-01260-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7467473 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-74674732020-09-11 Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone Ramaswamy, Krishnan Lechpammer, Stanislav Mardekian, Jack Huang, Ahong Schultz, Neil M. Sandin, Rickard Wang, Li Baser, Onur George, Daniel J. Adv Ther Original Research INTRODUCTION: Prostate cancer (PC) is the second leading cause of cancer death among US men and accounts for considerable healthcare expenditures. We evaluated economic outcomes in men with chemotherapy-naïve metastatic castration-resistant PC (mCRPC) treated with enzalutamide or abiraterone acetate plus prednisone (abiraterone). METHODS: We performed a retrospective analysis on 3174 men (18 years or older) utilizing the Veterans Health Administration (VHA) database from 1 April 2014 to 31 March 2018. Men with mCRPC were included if they had at least one pharmacy claim for enzalutamide or abiraterone (first claim date = index date) following surgical or medical castration, had no chemotherapy treatment within 12 months prior to the index date, and had continuous VHA enrollment for at least 12 months pre- and post-index date. Men were followed until death, disenrollment, or end of study and were 1:1 propensity score matched (PSM). All-cause and PC-related resource use and costs per patient per month (PPPM) in the 12 months post index were compared between matched cohorts. RESULTS: We identified 1229 men with mCRPC prescribed enzalutamide and 1945 prescribed abiraterone with mean ages of 74 and 73 years, respectively. After PSM, each cohort had 1160 patients. The enzalutamide cohort had fewer all-cause (2.51 vs 2.86; p < 0.0001) and PC-related outpatient visits (0.86 vs 1.03; p < 0.0001), with corresponding lower all-cause ($2588 vs $3115; p < 0.0001) and PC-related ($1356 vs $1775; p < 0.0001) PPPM outpatient costs compared with the abiraterone cohort. All-cause total costs (medical and pharmacy) PPPM ($8085 vs $9092; p = 0.0002) and PC-related total costs PPPM ($6321 vs $7280; p < 0.0001) were significantly lower in the enzalutamide cohort compared with the abiraterone cohort. CONCLUSIONS: Enzalutamide-treated men with chemotherapy-naïve mCRPC had significantly lower resource utilization and healthcare costs compared with abiraterone-treated men. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12325-020-01260-x) contains supplementary material, which is available to authorized users. Springer Healthcare 2020-02-28 2020 /pmc/articles/PMC7467473/ /pubmed/32112280 http://dx.doi.org/10.1007/s12325-020-01260-x Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third-party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Ramaswamy, Krishnan Lechpammer, Stanislav Mardekian, Jack Huang, Ahong Schultz, Neil M. Sandin, Rickard Wang, Li Baser, Onur George, Daniel J. Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title | Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title_full | Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title_fullStr | Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title_full_unstemmed | Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title_short | Economic Outcomes in Patients with Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone |
title_sort | economic outcomes in patients with chemotherapy-naïve metastatic castration-resistant prostate cancer treated with enzalutamide or abiraterone acetate plus prednisone |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467473/ https://www.ncbi.nlm.nih.gov/pubmed/32112280 http://dx.doi.org/10.1007/s12325-020-01260-x |
work_keys_str_mv | AT ramaswamykrishnan economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT lechpammerstanislav economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT mardekianjack economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT huangahong economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT schultzneilm economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT sandinrickard economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT wangli economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT baseronur economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone AT georgedanielj economicoutcomesinpatientswithchemotherapynaivemetastaticcastrationresistantprostatecancertreatedwithenzalutamideorabirateroneacetateplusprednisone |