Cost-effectiveness analysis of abiraterone acetate (AA) versus docetaxel (D) for the management of metastatic hormone naïve prostate cancer (mHNPC).

6514Background: Therapies previously reserved for castration resistant prostate cancer (CRPC) have demonstrated improved progression-free (PFS) and overall survival (OS) in mHNPC. Four randomized trials have provided level 1 evidence for using either D or AA in addition to androgen deprivation therapy (ADT) for mHNPC, but the cost-effectiveness of these options has not been compared. Methods: A Markov cohort model was developed to project cost-effectiveness of each treatment until disease progression. Survival curves for progression/death were abstracted and digitized from the CHAARTED and LATITUDE studies. Clinically or financially significant adverse events (AEs) were modeled (neutropenia, neutropenic fever, and severe fatigue); utility values were obtained from the literature. Drug costs were obtained from a range of sources (Average Wholesale Price; VA costs). Effectiveness was measured in PFS quality adjusted life years (PFS QALYs) and cost-effectiveness was calculated using incremental cost-effectiv...