Meta-analysis and economic evaluation of LH-RH agonists' depot formulations in advanced prostatic carcinoma

Abstract

The present study compares the relative efficacy, safety and cost of therapy of the following LH-RH agonists: buserelin acetate (Suprefact(R) Depot, Hoechst Marion Roussel), goserelin acetate (Zoladex(R) LA, Zeneca Pharma Inc.), and leuprolide acetate (Lupron(R) SR Depot, Abbott Laboratories Inc.). To support the conduct of a cost-minimization analysis in patients with advanced prostatic carcinoma their comparable efficacy and safety was first assessed using a meta-analysis technique. The absence of statistically significant differences among the 2 major end points, survival and progression-free survival was confirmed. The cost-minimization analysis for the depot formulations was conducted from the perspectives of the provincial formulary and the Ministry of Health, and considered 2 time horizons: 1 year, and mean survival time of 2.5 years. Cost differences among LH-RH agonists were sensitive to changes in dosing interval and patient survival time but, even when these parameters were varied, for a general population of patients with advanced prostate cancer, buserelin remained the most cost-saving treatment alternative among LH-RH agonists.