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. 2018 Dec 5;13(12):e0208063.
doi: 10.1371/journal.pone.0208063. eCollection 2018.

Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review

Thomas Grochtdreis  1 , Hans-Helmut König  1 , Alexander Dobruschkin  1 , Gunhild von Amsberg  2 , Judith Dams  1
Affiliations

Cost-effectiveness analyses and cost analyses in castration-resistant prostate cancer: A systematic review

Thomas Grochtdreis et al. PLoS One. .

Abstract

Background: Treatment of metastatic prostate cancer is associated with high personal and economic burden. Recently, new treatment options for castration-resistant prostate cancer became available with promising survival advantages. However, cost-effectiveness of those new treatment options is sometimes ambiguous or given only under certain circumstances. The aim of this study was to systematically review studies on the cost-effectiveness of treatments and costs of castration-resistant prostate cancer (CRPC) and metastasizing castration-resistant prostate cancer (mCRPC) on their methodological quality and the risk of bias.

Methods: A systematic literature search was performed in the databases PubMed, CINAHL Complete, the Cochrane Library and Web of Science Core Collection for costs-effectiveness analyses, model-based economic evaluations, cost-of-illness analyses and budget impact analyses. Reported costs were inflated to 2015 US$ purchasing power parities. Quality assessment and risk of bias assessment was performed using the Consolidated Health Economic Evaluation Reporting Standards checklist and the Bias in Economic Evaluations checklist, respectively.

Results: In total, 38 articles were identified by the systematic literature search. The methodological quality of the included studies varied widely, and there was considerable risk of bias. The cost-effectiveness treatments for CRPC and mCRPC was assessed with incremental cost-effectiveness ratios ranging from dominance for mitoxantrone to $562,328 per quality-adjusted life year gained for sipuleucel-T compared with prednisone alone. Annual costs for the treatment of castration-resistant prostate cancer ranged from $3,067 to $77,725.

Conclusion: The cost-effectiveness of treatments of CRPC strongly depended on the willingness to pay per quality-adjusted life year gained/life-year saved throughout all included costs-effectiveness analyses and model-based economic evaluations. High-quality cost-effectiveness analyses based on randomized controlled trials are needed in order to make informed decisions on the management of castration-resistant prostate cancer and the resulting financial impact on the healthcare system.

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Conflict of interest statement

Gunhild von Amsberg received honoraria from Sanofi, Astellas, Ipsen, Bristol-Myers Squibb, MSD, AstraZeneca and Roche for serving as a consultant/advisor. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart of the selection process based on the PRISMA statement [92].
See this image and copyright information in PMC

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