Cost–effectiveness analysis comparing degarelix with leuprolide in hormonal therapy for patients with locally advanced prostate cancer

Abstract

Degarelix, approved in the USA in 2008, is a gonadotropin-releasing hormone antagonist, representing one of the latest additions to androgen deprivation therapy (ADT). ADT is used as first-line therapy for locally advanced or metastatic prostate cancer with the aim to reduce testosterone to castrate levels. Like other gonadotropin-releasing hormone-antagonists, degarelix treatment results in rapid decrease in luteinizing hormone, follicle-stimulating hormone and testosterone levels without the associated risk of flare. Using one registration trial for degarelix with leuprolide as the active control, a cost–effectiveness analysis with a Markov model and a 20-year time horizon found the incremental cost–effectiveness ratio for degarelix to be US$245/quality-adjusted life years. Degarelix provides a cost-effective treatment for ADT among patients with locally advanced prostate cancer.

Keywords::

• ADT
• cost–effectiveness
• degarelix
• Markov simulation models
• prostate cancer
• QALY

Financial & competing interests disclosure

This study was supported by a contract from Ferring Pharmaceuticals to Hind T Hatoum & Company. HT Hatoum is president of Hind T Hatoum & Company. ED Crawford was the principal investigator for degarelix clinical trials and performs in an advisory capacity to Ferring Pharmaceuticals, the marketer of degarelix. S Kildegaard Nielsen is an employee of Ferring. S-J Lin is a senior analytic consultant for Hind T Hatoum & Company. DC Marshall is an employee of Ferring Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.