More than 50,000 male patients received hormonal therapy for metastatic prostate carcinoma in 1995.
Nonsteroidal antiandrogens, such as flutamide, when used in conjunction with castration, are effective in prolonging the time to progression of disease and survival.
Only one-third of newly diagnosed patients with metastatic prostate carcinoma receive flutamide.
Physicians may be reluctant to prescribe flutamide because of quality of life, toxicity, and cost considerations.
Physician focus groups evaluated quality of life factors for metastatic prostate cancer.
Using quality of life estimates with the National Cancer Institute's (NCI) 0036 clinical trial results, our revised model of flutamide use predicted that, for minimal disease, survival increased by 4.33 quality adjusted months (QAMs) at an incremental cost of $25,000 per quality adjusted life year (QALY) saved and for severe disease, survival increased by 4.11 QAM at a cost of $18,000 per QALY saved.
However, if quality of life estimates are used in conjunction with the Prostate Cancer Trialists'Collaborative Group (PCTCG) meta-analysis estimates, survival increased by 2.1 QAM at an incremental cost of $41,000 per QALY saved for persons with severe disease and increased by 2.6 QAM at an incremental cost of $53,700 per QALY saved for persons with minimal disease.
Using NCI 0036 trial data, flutamide has an incremental cost-effectiveness more favorable than mos...
Mots-clés Pascal : Carcinome, Prostate, Métastase, Homme, Flutamide, Chimiothérapie, Traitement, Analyse avantage coût, Economie santé, Qualité vie, Stade avancé, Antiandrogène, Anticancéreux, Tumeur maligne, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie, Composé non stéroïde
Mots-clés Pascal anglais : Carcinoma, Prostate, Metastasis, Human, Chemotherapy, Treatment, Cost benefit analysis, Health economy, Quality of life, Advanced stage, Antiandrogen, Antineoplastic agent, Malignant tumor, Urinary system disease, Male genital diseases, Prostate disease, Nonsteroid compound
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0253919
Code Inist : 002B02R02. Création : 199608.