@article{4390d6bc6e6f45b4995205b755e7459d,
title = "Economic Outcomes in Patients with Chemotherapy-Na{\"i}ve Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide or Abiraterone Acetate Plus Prednisone",
abstract = "Introduction: Prostate cancer (PC) is the second leading cause of cancer death among US men and accounts for considerable healthcare expenditures. We evaluated economic outcomes in men with chemotherapy-na{\"i}ve metastatic castration-resistant PC (mCRPC) treated with enzalutamide or abiraterone acetate plus prednisone (abiraterone). Methods: We performed a retrospective analysis on 3174 men (18 years or older) utilizing the Veterans Health Administration (VHA) database from 1 April 2014 to 31 March 2018. Men with mCRPC were included if they had at least one pharmacy claim for enzalutamide or abiraterone (first claim date = index date) following surgical or medical castration, had no chemotherapy treatment within 12 months prior to the index date, and had continuous VHA enrollment for at least 12 months pre- and post-index date. Men were followed until death, disenrollment, or end of study and were 1:1 propensity score matched (PSM). All-cause and PC-related resource use and costs per patient per month (PPPM) in the 12 months post index were compared between matched cohorts. Results: We identified 1229 men with mCRPC prescribed enzalutamide and 1945 prescribed abiraterone with mean ages of 74 and 73 years, respectively. After PSM, each cohort had 1160 patients. The enzalutamide cohort had fewer all-cause (2.51 vs 2.86; p < 0.0001) and PC-related outpatient visits (0.86 vs 1.03; p < 0.0001), with corresponding lower all-cause ($2588 vs $3115; p < 0.0001) and PC-related ($1356 vs $1775; p < 0.0001) PPPM outpatient costs compared with the abiraterone cohort. All-cause total costs (medical and pharmacy) PPPM ($8085 vs $9092; p = 0.0002) and PC-related total costs PPPM ($6321 vs $7280; p < 0.0001) were significantly lower in the enzalutamide cohort compared with the abiraterone cohort. Conclusions: Enzalutamide-treated men with chemotherapy-na{\"i}ve mCRPC had significantly lower resource utilization and healthcare costs compared with abiraterone-treated men.",
keywords = "Abiraterone acetate, Enzalutamide, Healthcare costs, Prostate cancer, Survival",
author = "Krishnan Ramaswamy and Stanislav Lechpammer and Jack Mardekian and Ahong Huang and Schultz, {Neil M.} and Rickard Sandin and Li Wang and Onur Baser and George, {Daniel J.}",
note = "Funding Information: The study, Rapid Service Fee, and Open Access fee were funded by Pfizer Inc. (New York, NY, USA) and Astellas Pharma, Inc. (Northbrook, IL, USA). This study was sponsored by Pfizer Inc. (New York, NY, USA), and Astellas Pharma, Inc. (Northbrook, IL, USA), the co-developers of enzalutamide, and was conducted by STATinMED (Plano, TX, USA). STATinMED received compensation from the sponsors for the overall conduct of the study and development of this manuscript. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis. Medical writing and editorial assistance funded by Pfizer Inc. (New York, NY, USA) and Astellas Pharma, Inc. (Northbrook, IL, USA) were provided by Stephanie Vadasz, PhD, and Dena McWain of Ashfield Healthcare Communications (Middletown, CT, USA). All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Krishnan Ramaswamy, Stanislav Lechpammer, Jack Mardekian, and Rickard Sandin are employees of Pfizer Inc. and own stock or stock options. Neil M. Schultz is an employee of Astellas Pharma Inc. and owns stock or stock options. Ahong Huang is an employee of and Li Wang is a former employee of STATinMED; STATinMED received compensation from the sponsors for the overall conduct of the study and development of this manuscript. Onur Baser and Daniel J. George have nothing to disclose. This study was exempt from institutional review board assessment because there was no extraction or use of any personally identifiable information. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2020",
month = may,
day = "1",
doi = "10.1007/s12325-020-01260-x",
language = "English (US)",
volume = "37",
pages = "2083--2097",
journal = "Advances in Therapy",
issn = "0741-238X",
publisher = "Health Communications Inc.",
number = "5",
}