Developing a Comprehensive Framework for Cost-Effectiveness Evaluation in Metastatic Castration-Sensitive Prostate...

Area of Science:

• Health Economics
• Oncology
• Health Technology Assessment

Background:

• Metastatic castration-sensitive prostate cancer (mCSPC) presents significant economic challenges, requiring cost-effective treatment strategies.
• Existing economic evaluation models for mCSPC exhibit methodological inconsistencies due to component variability.
• There is a need for an optimal framework to standardize economic evaluations and minimize structural variation in mCSPC.

Purpose of the Study:

• To review existing economic evaluations for mCSPC.
• To establish a comprehensive cost-effectiveness modelling framework for mCSPC.
• To support future economic evaluations and decision-making in mCSPC.

Main Methods:

• Conducted a systematic literature review (SLR) of economic evaluations in mCSPC.
• Reviewed Health Technology Assessments (HTAs) for critiques and limitations.
• Established a comprehensive cost-effectiveness modelling framework based on SLR and HTA findings.
• Performed additional SLRs to identify cost, resource utilization, and health state utility data.

Main Results:

• Markov models and partitioned survival models (PSMs) are prevalent in mCSPC economic evaluations.
• A novel optimal framework utilizing a semi-Markov structure is proposed for mCSPC.
• The proposed semi-Markov framework offers enhanced flexibility by allowing time-dependent transition rates.
• Key sources for cost and utility data were identified through the SLR.

Conclusions:

• The developed optimal framework aligns with methodologies recommended by the Innovative Medicine Initiative (IMI) PIONEER group.
• This framework consolidates existing modeling precedents in mCSPC.
• It will aid in the cost-effectiveness assessment of mCSPC treatments by incorporating healthcare resource utilization and utility data.