Pharmacoeconomic analysis of enzalutamide and abiraterone for treatment of chemotherapy naive patients with metastatic castration resistant prostate cancer

Introduction. Enzalutamide and abiraterone are used for treatment of metastatic castration resistant prostate cancer (mCRPC). Both drugs were proved to be effective in randomized control trials.

Objective. This pharmacoeconomic evaluation compared enzalutamide and abiraterone used prior to chemotherapy in patients with mCRPC from the Russian healthcare system perspective.

Materials and methods. Based on clinical trials results we proposed an mCRPC Markov chain stochastic process model and calculated medical costs per 1 mCRPC patient. We also conducted cost – effectiveness, cost – utility and budget impact analysis.

Results. Monthly medication costs for enzalutamide was 29 478 rubles (11.7 %) less than for abiraterone + prednisolone. The 4 year total medical costs for enzalutamide was 318 thousand rubles (5.0 %) less than for abiraterone + prednisolone. Enzalutamide was also found to be cost – effective compared to abiraterone.

Conclusions. Enzalutamide is a rational option for mCRPC treatment.