Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer

Detalhes bibliográficos
Autor(a) principal: Aguiar, Pedro Nazareth, Jr.
Data de Publicação: 2017
Outros Autores: Noia Barreto, Carmelia Maria, Gutierres, Barbara de Souza, Tadokoro, Hakaru [UNIFESP], Lopes, Gilberto de Lima, Jr.
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
dARK ID: ark:/48912/00130000031tk
Texto Completo: http://dx.doi.org/10.1590/S1679-45082017GS4017
https://repositorio.unifesp.br/handle/11600/53490
Resumo: Objective: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer. Methods: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated. Results: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease. Conclusion: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.
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spelling Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancerCusto-efetividade da adição de quimioterapia ao tratamento hormonal do câncer de próstata metastático sensível a hormônio ou localizado de alto riscoEconomics, pharmaceuticalProstatic neoplasms/drug therapyCost controlPublic healthFarmacoeconomiaNeoplasias da próstata/tratamento farmacológicoControle de custosSaúde públicaObjective: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer. Methods: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated. Results: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease. Conclusion: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.Objetivo: Avaliar a relação custo-efetividade da adição de quimioterapia hormonal em pacientes com câncer de próstata metastático sensível a hormônio ou localizado de alto risco. Métodos: Um modelo de decisão analítico foi desenvolvido para determinar o custo-efetividade da adição de quimioterapia versus a monoterapia de privação de andrógeno para pacientes com câncer de próstata metastático hormônio-sensível e pacientes de alto risco com câncer de próstata não metastático. O custo-efetividade em pacientes metastáticos com um alto volume da doença foi verificado isoladamente. Os dados do modelo foram obtidos de ensaios clínicos randomizados utilizando custos de aquisição de medicamentos no Brasil. Os custos de terapias pós-progressão também foram incluídos no modelo. Os efeitos foram expressos em anos de vida ajustados por qualidade, e foram calculadas as razões de custo-efetividade incremental. Resultados: A adição de quimioterapia levou a um ganho de anos de vida ajustados por qualidade para todos os doentes. Este incremento foi seis vezes maior para os pacientes com doença metastática de alto volume. Nestes pacientes, as taxas do custo incremental por anos de vida ajustados por qualidade foram até 74% mais baixos do que o aumento das taxas dos pacientes com doença não metastática. Conclusão: A adição de quimioterapia foi mais custo-efetiva para pacientes com doença metastática de alto volume.Fac Med ABC, Santo Andre, SP, BrazilBeneficencia Portuguesa Sao Paulo, Sao Paulo, SP, BrazilUniv Paulista, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Sao Paulo, SP, BrazilMiami Univ, Sylvester Comprehens Canc Ctr, Oxford, OH 45056 USAUniv Fed Sao Paulo, Sao Paulo, SP, BrazilWeb of ScienceInst Israelita Ensino & Pesquisa Albert Einstein2020-06-26T16:30:20Z2020-06-26T16:30:20Z2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion349-354application/pdfapplication/pdfhttp://dx.doi.org/10.1590/S1679-45082017GS4017Einstein-Sao Paulo. Sao Paulo Sp, v. 15, n. 3, p. 349-354, 2017.10.1590/S1679-45082017GS4017S1679-45082017000300349-en.pdfS1679-45082017000300349-pt.pdf1679-4508S1679-45082017000300349https://repositorio.unifesp.br/handle/11600/53490WOS:000416710300019ark:/48912/00130000031tkporEinstein-Sao PauloSao Paulo Spinfo:eu-repo/semantics/openAccessAguiar, Pedro Nazareth, Jr.Noia Barreto, Carmelia MariaGutierres, Barbara de SouzaTadokoro, Hakaru [UNIFESP]Lopes, Gilberto de Lima, Jr.reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-11T01:11:11Zoai:repositorio.unifesp.br/:11600/53490Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-12-11T19:53:56.700906Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
Custo-efetividade da adição de quimioterapia ao tratamento hormonal do câncer de próstata metastático sensível a hormônio ou localizado de alto risco
title Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
spellingShingle Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
Aguiar, Pedro Nazareth, Jr.
Economics, pharmaceutical
Prostatic neoplasms/drug therapy
Cost control
Public health
Farmacoeconomia
Neoplasias da próstata/tratamento farmacológico
Controle de custos
Saúde pública
title_short Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
title_full Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
title_fullStr Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
title_full_unstemmed Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
title_sort Cost effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer
author Aguiar, Pedro Nazareth, Jr.
author_facet Aguiar, Pedro Nazareth, Jr.
Noia Barreto, Carmelia Maria
Gutierres, Barbara de Souza
Tadokoro, Hakaru [UNIFESP]
Lopes, Gilberto de Lima, Jr.
author_role author
author2 Noia Barreto, Carmelia Maria
Gutierres, Barbara de Souza
Tadokoro, Hakaru [UNIFESP]
Lopes, Gilberto de Lima, Jr.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Aguiar, Pedro Nazareth, Jr.
Noia Barreto, Carmelia Maria
Gutierres, Barbara de Souza
Tadokoro, Hakaru [UNIFESP]
Lopes, Gilberto de Lima, Jr.
dc.subject.por.fl_str_mv Economics, pharmaceutical
Prostatic neoplasms/drug therapy
Cost control
Public health
Farmacoeconomia
Neoplasias da próstata/tratamento farmacológico
Controle de custos
Saúde pública
topic Economics, pharmaceutical
Prostatic neoplasms/drug therapy
Cost control
Public health
Farmacoeconomia
Neoplasias da próstata/tratamento farmacológico
Controle de custos
Saúde pública
description Objective: To assess the cost-effectiveness of chemohormonal therapy in patients with metastatic hormone-sensitive and non-metastatic high-risk prostate cancer. Methods: An analytical decision model was developed to determine the cost-effectiveness of chemohormonal therapy versus androgen deprivation therapy alone in patients with metastatic hormone-sensitive prostate cancer and patients with non-metastatic high-risk prostate cancer. The cost-effectiveness in metastatic patients with a high-volume disease was assessed separately. The model used data from randomized clinical trials and drug acquisition costs in Brazil. In addition, the costs of post-progression therapies have been included in this model. The benefits to health are expressed as the quality-adjusted life-years, and the incremental cost-effectiveness ratios were calculated. Results: Chemohormonal therapy may be associated with improved quality-adjusted life-years for all patient. The improvement was more than six times greater for patients with high-volume metastatic disease. In these patients, the incremental cost-effectiveness ratios were up to 74% lower than the incremental cost-effectiveness ratios of patients with non-metastatic disease. Conclusion: Chemohormonal therapy has been more cost-effective in patients with high-volume metastatic disease.
publishDate 2017
dc.date.none.fl_str_mv 2017
2020-06-26T16:30:20Z
2020-06-26T16:30:20Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S1679-45082017GS4017
Einstein-Sao Paulo. Sao Paulo Sp, v. 15, n. 3, p. 349-354, 2017.
10.1590/S1679-45082017GS4017
S1679-45082017000300349-en.pdf
S1679-45082017000300349-pt.pdf
1679-4508
S1679-45082017000300349
https://repositorio.unifesp.br/handle/11600/53490
WOS:000416710300019
dc.identifier.dark.fl_str_mv ark:/48912/00130000031tk
url http://dx.doi.org/10.1590/S1679-45082017GS4017
https://repositorio.unifesp.br/handle/11600/53490
identifier_str_mv Einstein-Sao Paulo. Sao Paulo Sp, v. 15, n. 3, p. 349-354, 2017.
10.1590/S1679-45082017GS4017
S1679-45082017000300349-en.pdf
S1679-45082017000300349-pt.pdf
1679-4508
S1679-45082017000300349
WOS:000416710300019
ark:/48912/00130000031tk
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Einstein-Sao Paulo
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 349-354
application/pdf
application/pdf
dc.coverage.none.fl_str_mv Sao Paulo Sp
dc.publisher.none.fl_str_mv Inst Israelita Ensino & Pesquisa Albert Einstein
publisher.none.fl_str_mv Inst Israelita Ensino & Pesquisa Albert Einstein
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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