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dc.contributor.authorClarke, CS
dc.contributor.authorHunter, RM
dc.contributor.authorGabrio, A
dc.contributor.authorBrawley, CD
dc.contributor.authorIngleby, FC
dc.contributor.authorDearnaley, DP
dc.contributor.authorMatheson, D
dc.contributor.authorAttard, G
dc.contributor.authorRush, HL
dc.contributor.authorJones, RJ
dc.contributor.authorCross, W
dc.contributor.authorParker, C
dc.contributor.authorRussell, JM
dc.contributor.authorMillman, R
dc.contributor.authorGillessen, S
dc.contributor.authorMalik, Z
dc.contributor.authorLester, JF
dc.contributor.authorWylie, J
dc.contributor.authorClarke, NW
dc.contributor.authorParmar, MKB
dc.contributor.authorSydes, MR
dc.contributor.authorJames, ND
dc.coverage.spatialUnited States
dc.date.accessioned2022-07-12T14:53:58Z
dc.date.available2022-07-12T14:53:58Z
dc.date.issued2022-01-01
dc.identifierPONE-D-22-01674
dc.identifier.citationPLoS One, 2022, 17 (6), pp. e0269192 -en_US
dc.identifier.issn1932-6203
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/5211
dc.identifier.eissn1932-6203
dc.identifier.eissn1932-6203
dc.identifier.doi10.1371/journal.pone.0269192
dc.identifier.doi10.1371/journal.pone.0269192
dc.description.abstractAdding abiraterone acetate (AA) plus prednisolone (P) to standard of care (SOC) improves survival in newly diagnosed advanced prostate cancer (PC) patients starting hormone therapy. Our objective was to determine the value for money to the English National Health Service (NHS) of adding AAP to SOC. We used a decision analytic model to evaluate cost-effectiveness of providing AAP in the English NHS. Between 2011-2014, the STAMPEDE trial recruited 1917 men with high-risk localised, locally advanced, recurrent or metastatic PC starting first-line androgen-deprivation therapy (ADT), and they were randomised to receive SOC plus AAP, or SOC alone. Lifetime costs and quality-adjusted life-years (QALYs) were estimated using STAMPEDE trial data supplemented with literature data where necessary, adjusting for baseline patient and disease characteristics. British National Formulary (BNF) prices (£98/day) were applied for AAP. Costs and outcomes were discounted at 3.5%/year. AAP was not cost-effective. The incremental cost-effectiveness ratio (ICER) was £149,748/QALY gained in the non-metastatic (M0) subgroup, with 2.4% probability of being cost-effective at NICE's £30,000/QALY threshold; and the metastatic (M1) subgroup had an ICER of £47,503/QALY gained, with 12.0% probability of being cost-effective. Scenario analysis suggested AAP could be cost-effective in M1 patients if priced below £62/day, or below £28/day in the M0 subgroup. AAP could dominate SOC in the M0 subgroup with price below £11/day. AAP is effective for non-metastatic and metastatic disease but is not cost-effective when using the BNF price. AAP currently only has UK approval for use in a subset of M1 patients. The actual price currently paid by the English NHS for abiraterone acetate is unknown. Broadening AAP's indication and having a daily cost below the thresholds described above is recommended, given AAP improves survival in both subgroups and its cost-saving potential in M0 subgroup.
dc.formatElectronic-eCollection
dc.format.extente0269192 -
dc.languageeng
dc.language.isoengen_US
dc.publisherPublic Library of Science (PLoS)en_US
dc.relation.ispartofPLoS One
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectAbiraterone Acetate
dc.subjectAcetates
dc.subjectAndrogen Antagonists
dc.subjectCost-Benefit Analysis
dc.subjectHormones
dc.subjectHumans
dc.subjectMale
dc.subjectPrednisolone
dc.subjectPrednisone
dc.subjectProstatic Neoplasms
dc.subjectState Medicine
dc.titleCost-utility analysis of adding abiraterone acetate plus prednisone/prednisolone to long-term hormone therapy in newly diagnosed advanced prostate cancer in England: Lifetime decision model based on STAMPEDE trial data.en_US
dc.typeJournal Article
dcterms.dateAccepted2022-05-14
dc.date.updated2022-07-12T14:53:28Z
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1371/journal.pone.0269192en_US
rioxxterms.licenseref.startdate2022-01-01
rioxxterms.typeJournal Article/Reviewen_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/35653395
pubs.issue6
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Prostate and Bladder Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/ImmNet
pubs.publication-statusPublished online
pubs.volume17
icr.researchteamClinic Acad RT Dearnaleyen_US
icr.researchteamProstate & Bladder Canceren_US
dc.contributor.icrauthorDearnaley, David
dc.contributor.icrauthorParker, Chris
dc.contributor.icrauthorJames, Nicholas
icr.provenanceDeposited by Mr Arek Surman on 2022-07-12. Deposit type is initial. No. of files: 1. Files: Cost-utility analysis of adding abiraterone acetate plus prednisoneprednisolone to long-term hormone therapy in newly diagno.pdf


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