@article{Beca_Majeed_Chan_Hotte_Loblaw_Hoch_2019, title={Cost-effectiveness of docetaxel in high-volume hormone-sensitive metastatic prostate cancer}, volume={13}, url={https://cuaj.ca/index.php/journal/article/view/5889}, DOI={10.5489/cuaj.5889}, abstractNote={<p><strong>Introduction:</strong> Three pivotal trials have considered the addition of docetaxel (D) chemotherapy to conventional androgen-deprivation therapy (ADT) for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC). While an initial small trial was inconclusive, two larger trials demonstrated significant clinical benefit, including pronounced survival benefits (added 17 months) among patients with high-volume metastatic disease. Given the evolving clinical evidence, the cost-effectiveness of this approach warrants exploration.</p> <p><strong>Methods:</strong> The cost-effectiveness of six cycles of ADT+D compared to ADT alone to treat patients with high-volume mHSPC was assessed from a Canadian public payer perspective. We included three health states: HSPC, metastatic castration-resistant prostate cancer (CRPC), and death. Survival data were obtained from the CHAARTED trial, which reported outcomes specifically for high-volume disease. We used Ontario costs data and utilities from the literature.</p> <p><strong>Results:</strong> In the base case analysis, ADT+D cost an additional $25 757 and produced an extra 1.06 quality-adjusted life years (QALYs), resulting in an incremental cost-effectiveness ratio (ICER) of $24 226/QALY gained. Results from one-way sensitivity analysis across wide ranges of estimates and a range of scenarios, including an alternate model structure, produced ICERs below $35 000/ QALY gained in all cases.</p> <p><strong>Conclusions:</strong> The use of D with ADT in high-volume mHSPC appears to be an economically attractive treatment approach. The findings were consistent with other studies and robust in sensitivity analysis across a variety of scenarios.</p>}, number={12}, journal={Canadian Urological Association Journal}, author={Beca, Jaclyn and Majeed, Habeeb and Chan, Kelvin K.W. and Hotte, Sebastian J. and Loblaw, Andrew and Hoch, Jeffrey S.}, year={2019}, month={Apr.}, pages={396–403} }