Comment on: 'Cost-Effectiveness of Niraparib Versus Routine Surveillance, Olaparib and Rucaparib for the Maintenance Treatment of Patients with Ovarian Cancer in the United States'

Autor: Terri Cameron, Josh Bedel, Jeff Isaacson, Katrine Wallace, Lara Maloney, Sandra Goble
Rok vydání: 2019
Předmět:
Oncology
medicine.medical_specialty
Indazoles
Indoles
Cost effectiveness
Cost-Benefit Analysis
Poly(ADP-ribose) Polymerase Inhibitors
Piperazines
Decision Support Techniques
Olaparib
Health administration
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Piperidines
Internal medicine
medicine
Humans
Original Research Article
030212 general & internal medicine
Progression-free survival
Intensive care medicine
Rucaparib
Letter to the Editor
Survival rate
health care economics and organizations
Quality of Life Research
Ovarian Neoplasms
Pharmacology
Health economics
business.industry
Health Policy
Public health
Public Health
Environmental and Occupational Health
medicine.disease
Chemotherapy regimen
Progression-Free Survival
United States
Quality-adjusted life year
Survival Rate
chemistry
030220 oncology & carcinogenesis
Phthalazines
Female
Quality-Adjusted Life Years
Ovarian cancer
business
Zdroj: Pharmacoeconomics
ISSN: 1179-2027
1170-7690
DOI: 10.1007/s40273-019-00815-3
Popis: Objectives The aim was to evaluate the cost-effectiveness of niraparib compared with routine surveillance (RS), olaparib and rucaparib for the maintenance treatment of patients with recurrent ovarian cancer (OC). Methods A decision-analytic model estimated the cost per quality-adjusted life-year (QALY) gained for niraparib versus RS, olaparib, and rucaparib from a US payer perspective. The model considered recurrent OC patients with or without germline BRCA mutations (gBRCAmut and non-gBRCAmut), who were responsive to their last platinum-based chemotherapy regimen. Model health states were: progression-free disease, progressed disease and dead. Mean progression-free survival (PFS) was estimated using parametric survival distributions based on ENGOT-OV16/NOVA (niraparib phase III trial), ARIEL3 (rucaparib phase III trial) and Study 19 (olaparib phase II trial). Mean overall survival (OS) benefit was estimated as double the mean PFS benefit based on the relationship between PFS and OS observed in Study 19. Costs included: drug, chemotherapy, monitoring, adverse events, and terminal care. EQ-5D utilities were estimated from trial data. Results Compared to RS, niraparib was associated with an incremental cost-effectiveness ratio (ICER) of US$68,287/QALY and US$108,287/QALY for gBRCAmut and non-gBRCAmut, respectively. Compared to olaparib and rucaparib, niraparib decreased costs and increased QALYs, with a cost saving of US$8799 and US$22,236 versus olaparib and US$198,708 and US$73,561 versus rucaparib for gBRCAmut and non-gBRCAmut, respectively. Conclusions Niraparib was estimated to be less costly and more effective compared to olaparib and rucaparib, and the ICER fell within an acceptable range compared to RS. Therefore, niraparib may be considered a cost-effective maintenance treatment for patients with recurrent OC. Electronic supplementary material The online version of this article (10.1007/s40273-018-0745-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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