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Updated: Nov 17, 2025
A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Cost-Effectiveness of Genomic Test-Directed Olaparib for Metastatic Castration-Resistant Prostate Cancer
Dan Su1, Bin Wu2, Lizheng Shi3
1Department of Pharmacy, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui, China.
Abstract:
Purpose: The effectiveness of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor olaparib for metastatic castration-resistant prostate cancer (MCRPC) with multiple loss-of-function alterations in genes that are involved in DNA repair has been demonstrated. We aimed to evaluate the cost-effectiveness of genomic test-directed olaparib on MCRPC from the US payer perspective. Methods: A partitioned survival model was adopted to project the disease course of MCRPC had at least one gene alteration in BRCA1, BRCA2 and ATM (Scenario A) and has alterations in any of all 15 prespecified genes (Scenario B) after next-generation sequencing test. The efficacy and toxicity data were gathered from the PROfound trial. Clinical probabilities related to survival were estimated from the reported survival probabilities in each PROfound group. Cost and health preference data were derived from the literature. The incremental cost-effectiveness ratio (ICER) was measured. Subgroup analysis and sensitivity analysis were performed for exploring the model uncertainties. Results: Olaparib yielded an additional 0.063 and 0.068 of quality-adjusted life year (QALY) with the augmented cost of $7,382 and saved the cost of $ 1,980 compared to standard care in scenario A and B, respectively, which yielded an ICER of $116,903/QALY and a cost-saving option. The lower weekly cost related to olaparib treatment led to the dominant findings in scenario B. The varied results between scenario A and B could be partly explained by different the number need to screen for identifying eligible patients who could be administered with olaparib, which sharply augmented the costs of the olaparib arm in scenario A. Subgroup analysis and sensitivity analysis revealed the results were generally robust in both of two scenarios. Conclusion: The genomic test-directed olaparib is a preferred option compared with standard care strategy for men with MCRPC who had any of all 15 prespecified genes.
Insights
Genomic testing-directed olaparib is a cost-effective treatment for metastatic castration-resistant prostate cancer (MCRPC). This approach offers improved quality-adjusted life years (QALYs) and is a preferred option over standard care for eligible patients.
Area of Science:
- Oncology
- Genomics
- Health Economics
Background:
- Poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors, like olaparib, show effectiveness in metastatic castration-resistant prostate cancer (MCRPC) with DNA repair gene alterations.
- Genomic testing is crucial for identifying patients who may benefit from targeted therapies.
Purpose of the Study:
- To evaluate the cost-effectiveness of using genomic testing to guide olaparib treatment for MCRPC from a US payer perspective.
- To compare the outcomes of olaparib versus standard care in MCRPC patients with specific gene alterations.
Main Methods:
- A partitioned survival model was used to project disease course and costs.
- Efficacy and toxicity data were sourced from the PROfound trial.
- Clinical probabilities, costs, and health preferences were derived from literature and trial data.
Main Results:
- Olaparib provided additional quality-adjusted life years (QALYs) in both evaluated scenarios (Scenario A: 0.063 QALYs, Scenario B: 0.068 QALYs).
- Scenario A resulted in an incremental cost-effectiveness ratio (ICER) of $116,903/QALY, while Scenario B was a cost-saving option.
- Results were robust across subgroup and sensitivity analyses, with Scenario B showing dominant findings due to lower screening costs.
Conclusions:
- Genomic test-directed olaparib is a preferred treatment strategy compared to standard care for men with MCRPC.
- Targeting patients with alterations in any of 15 prespecified genes (Scenario B) demonstrates superior cost-effectiveness.
- The number of patients needing screening significantly impacts the cost-effectiveness in Scenario A.
