Olaparib as first line in BRCA-mutated advanced ovarian carcinoma: Is it cost-effective in Spain?

Area of Science:

• Oncology
• Health Economics
• Pharmacoeconomics

Background:

• Advanced high-grade serous ovarian carcinoma (HGSOC) with BRCA mutations presents a significant treatment challenge.
• Maintenance therapy plays a crucial role in improving outcomes for HGSOC patients.
• The funding of olaparib by the Spanish National Health Service (SNHS) necessitates a cost-effectiveness evaluation.

Purpose of the Study:

• To estimate the cost-effectiveness of olaparib as first-line maintenance monotherapy for advanced HGSOC patients with BRCA mutations in Spain.
• To compare the costs and quality-adjusted life years (QALYs) of olaparib versus no maintenance treatment from the SNHS perspective.

Main Methods:

• A semi-Markov model with one-month cycles was developed for the Spanish healthcare setting.
• The model incorporated clinical data from the SOLO1 study and direct healthcare costs.
• A 50-year time horizon, a 3% discount rate, and probabilistic sensitivity analysis (PSA) were utilized, with a cost-effectiveness threshold of €25,000/QALY.

Main Results:

• Olaparib first-line maintenance treatment incurred an additional cost of €29,245.44, yielding 2.00 additional QALYs compared to no maintenance treatment.
• The incremental cost-effectiveness ratio (ICER) was €14,653.2/QALY, indicating cost-effectiveness.
• PSA revealed that 92.1% of simulations fell below the €25,000/QALY threshold, and olaparib demonstrated a 2-year improvement in overall survival.

Conclusions:

• Olaparib is a cost-effective first-line maintenance treatment option for advanced HGSOC patients with BRCA mutations in Spain.
• The findings support the use of olaparib within the SNHS for this patient population.
• The economic evaluation provides evidence for the value of olaparib in improving patient outcomes and survival.