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Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia.
Yong, Chee Meng; Yehgambaram, Prathepamalar A P; Lee, Shaun Wen Huey.
Afiliación
  • Yong CM; Department of Gynaecology, Hospital Ampang, Ampang, Selangor, Malaysia.
  • Yehgambaram PAP; Radiology and Oncology Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
  • Lee SWH; School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.
PLoS One ; 19(2): e0298130, 2024.
Article en En | MEDLINE | ID: mdl-38300930
ABSTRACT

INTRODUCTION:

Ovarian cancer is one of the most common cancer among women in Malaysia. Patients with ovarian cancer are often diagnosed at an advanced stage. Despite initial response to surgery and chemotherapy, most patients will experience a relapse. Olaparib has been reported have promising effects among BRCA mutated ovarian cancer patients. This study aimed to evaluate the cost-effectiveness of olaparib as a maintenance therapy for BRCA ovarian cancer in Malaysia.

METHODS:

We developed a four-state partitioned survival model which compared treatment with olaparib versus routine surveillance (RS) from a Malaysian healthcare perspective. Mature overall survival (OS) data from the SOLO-1 study were used and extrapolated using parametric models. Medication costs and healthcare resource usage costs were derived from local inputs and publications. Deterministic and probabilistic sensitivity analyses (PSA) were performed to explore uncertainties.

RESULTS:

In Malaysia, treating patients with olaparib was found to be more costly compared to RS, with an incremental cost of RM149,858 (USD 33,213). Patients treated with olaparib increased life years by 3.05 years and increased quality adjusted life years (QALY) by 2.76 (9.45 years vs 6.40 years; 7.62 vs 4.86 QALY). This translated to an incremental cost-effectiveness ratio (ICER) of RM 49,159 (USD10,895) per life year gained and RM54,357 (USD 12,047) per QALY gained, respectively. ICERs were most sensitive to time horizon of treatment, discount rate for outcomes, cost of treatment and health state costs, but was above the RM53,770/QALY threshold.

CONCLUSION:

The use of olaparib is currently not a cost-effective strategy compared to routine surveillance based upon the current price in Malaysia for people with ovarian cancer with BRCA mutation, despite the improvement in overall survival.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Ftalazinas / Piperazinas / Análisis de Costo-Efectividad Tipo de estudio: Health_economic_evaluation Aspecto: Patient_preference Límite: Female / Humans País/Región como asunto: Asia Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Ftalazinas / Piperazinas / Análisis de Costo-Efectividad Tipo de estudio: Health_economic_evaluation Aspecto: Patient_preference Límite: Female / Humans País/Región como asunto: Asia Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Estados Unidos