Health-economic review of zoledronic acid for the management of skeletal-related events in bone-metastatic prostate cancer

Figures & data

Figure 1. Study retrieval.

ASCO: American Society of Clinical Oncology; CRD: Center for Reviews and Dissemination; ECCO: The European Cancer Organisation; HTA: Health and Technology Assessment; ISPOR: International Society for Pharmacoeconomics and Outcomes Research;

NHS: National Health Service; QALY: Quality-adjusted life year; SRE: Skeletal-related event;

Table 1. Cost–effectiveness analyses of zoledronic acid versus no therapy or pamidronate in prostate cancer patients with bone metastases.

Study (year)	Country	Horizon (months)	Cost diff.			QALY diff.	SRE diff.	CE end point		Ref.
			Drug/admin	SRE	Total			Cost/QALY	Cost/SRE
ZOL vs NT
Botteman et al. (2009)	France	15	€2925	-€2659	€266	0.036	-0.83	€7,447	NR	[28]
Botteman et al. (2006)	Canada	24	NR	NR	$7,394	0.094	-0.93	$78,366	NR	[27]
Carter et al. (2011)	France	15	€3680	-€2396	€1,284	0.036	-0.76	€36,007	NR	[22]
Carter et al. (2011)	Germany	15	€3446	-€2606	€841	0.036	-0.76	€23,582	NR	[22]
Carter et al. (2011)	The Netherlands	15	€3364	-€3326	€87	0.036	-0.76	€2430	NR	[22]
Carter et al. (2011)	Portugal	15	€3704	-€3617	€309	0.036	-0.76	€8655	NR	[22]
El Ouagari and Baladi (2011)	Canada	15	$6910	-$432	$6,478	NR	-0.11	NR	$32,378	[33]
Reed et al. (2004)	Global	15	$5353	NR	$324	0.036	-0.11	$159,200	$12,300	[24]
ZOL vs PAM
Botteman et al. (2006)	Canada	24	NR	NR	$1719	0.094	-0.93	$18,343	$7950	[27]
ZOL vs PAM/NT
Carter et al. (2011)	The UK	15	£2419	-£1639	£2419	0.036	-0.83	£21,874	NR	[31]

Admin: Administration; CE: Cost–effectiveness; Diff.: Difference; NR: Not reported; NT: No therapy; PAM: Pamidronate; QALY: Quality-adjusted life year;

SRE: Skeletal-related event; ZOL: Zoledronic acid.

Table 2. Description of cost–effectiveness analyses of zoledronic acid and denosumab in prostate cancer patients with bone metastases.

Comparators	Study (year)	Country	Horizon	Population	Efficacy assumption	Cost diff.			QALY diff.	SRE diff.	CE end point		Ref.
						Drug/admin	SRE	Total			Cost/QALY	Cost/SRE
DMAB vs BSC	Ford et al. (2011)	The UK											[23]
	No-PAS^† Amgen	The UK	Lifetime	SRE-N	Pooled	NR	NR	£3993	0.039	NR	£102,067	NR
	PAS Amgen	The UK	Lifetime	SRE-N	Pooled	NR	NR	£2790	0.039	NR	£71,320	NR
DMAB vs ZOL	Lothgren et al. (2011)	The Netherlands	Lifetime	All		NR	NR	$542	0.013	-0.16	€42,933	€3360	[32]
	Snedecor et al. (2011)	The USA	27 months	All		$7314	-$1924	$5390	0.004	-0.25	$1,248,051	NR	[29]
	Stopeck et al. (2012)	The USA	Lifetime	All‡		$15,431	-$8522	$6910	0.14	-0.81	$49.405	$8567	[25]
	Xie et al. (2011)	The USA	12 months	All		$8270	-$488	$7813	NR	-0.11	NR	$71,027	[26]
	Yu et al. (2011)	The USA	12 months	All		NR	NR	$7355	NR	-0.11	NR	$66,864	[30]
	Ford et al. (2011)	The UK											[23]
	No-PAS^† Amgen NICE AG NICE AG NICE AG NICE AG NICE AG NICE AG	The UK The UK The UK The UK The UK The UK The UK	Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime	SRE-E All SRE-N SRE-E All SRE-N SRE-E	Pooled Pooled Pooled Pooled Pooled Nai Exp	NR NR NR NR NR NR NR	-£200 NR NR NR NR NR NR	£922 £941 £897 £1061 £1078 £1066 £1109	0.006 0.02 0.025 0.006 0.01 0.011 0.004	-0.04 -0.228 -0.265 -0.128 -0.114 -0.124 -0.088	£157,276 £46,976 £35,732 £167,503 £113,237 £93,575 £249,575	NR NR NR NR NR NR NR
	PAS Amgen NICE AG NICE AG NICE AG NICE AG NICE AG NICE AG	The UK The UK The UK The UK The UK The UK The UK	Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime	SRE-E All SRE-N SRE-E All SRE-N SRE-E	Pooled Pooled Pooled Pooled Pooled Nai Exp	NR NR NR NR NR NR NR	-£200 NR NR NR NR NR NR	-£281 -£243 -£287 -£123 -£107 -£118 -£76	0.006 0.02 0.025 0.006 0.01 0.011 0.004	-0.040 -0.228 -0.265 -0.128 -0.114 -0.124 -0.088	Dom Dom Dom Dom Dom Dom Dom	NR NR NR NR NR NR NR

^†Specifically for Ford et al., results are stratified by model source (Amgen submission to NICE [i.e., Amgen] or Ford and colleagues adaptation for NICE [NICE AG]), patient group (SRE-E, SRE-N, or all), source of SRE hazard and risk ratios (i.e., pooled across all patients [Pooled], from SRE-E patients [Exp], or from SRE-N patients [Nai]), and whether the patient access scheme was (PAS) or was not (no-PAS) used.

^‡Indicates that the analysis was supplemented with nontrial data drawn from an analysis comprised mostly of patients who were SRE-experienced.

Admin: Administration; BSC: Best supportive care; CE: Cost–effectiveness; Diff.: Difference; Dom: Dominated; DMAB: Denosumab; NICE AG: NICE Assessment Group; NR: Not reported; PAS: Patient access scheme; QALY: Quality-adjusted life year; SRE: Skeletal-related event; SRE-E: SRE-experienced; SRE-N: SRE-naive; ZOL: Zoledronic acid.

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