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RT Added to ADT Cost-Effective vs ADT Alone for Metastatic Prostate Cancer

January 28, 2021

Incorporating radiation therapy (RT) with androgen deprivation therapy (ADT) is cost-effective for low-volume metastatic hormone-sensitive prostate cancer compared with ADT alone, according to a recent study published in JAMA Network Open (2021;[1]:e2033787. doi:10.1001/jamanetworkopen.2020.33787).

Nataniel H Lester-Coll, MD, Division of Radiation Oncology, University of Vermont Larner College of Medicine (Burlington, VT), and colleagues conducted an economic evaluation aimed to assess the cost-effectiveness of adding RT to ADT for low-volume metastatic hormone-sensitive prostate cancer, using microsimulation modeling.

The microsimulation model included a simulated group of 10,000 men with low-volume metastatic hormone-sensitive prostate cancer. Data was collected and evaluated from January 18, 2019, through July 4, 2020.

The main outcomes measures included net quality-adjusted life-years (QALYs), costs in US dollars, and incremental cost-effectiveness ratios (ICERs). The treatment associated with higher QALYs at lower costs was considered dominant.

The combination of prostate RT and ADT was a dominant strategy compared to ADT alone. At 37 months follow-up, RT plus ADT increased QALYs by 0.16 and reduced net costs by $19,472. At life-time follow-up, QALYs increased 0.81 and resulted in savings of $30,229.

The combination of PRT and ADT is associated with reduced net costs and improved quality-adjusted life-years, conveying that it’s a dominant cost-effective strategy for treating men with low-volume metastatic hormone-sensitive prostate cancer, when compared to treating with ADT alone.—Marta Rybczynski

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