Olaparib Proves Cost-Effective as First-Line Maintenance Therapy in Ovarian Cancer Patients With BRCA Mutation

After a phase 3 clinical trial showed that olaparib is a successful maintenance therapy for patients with newly diagnosed advanced ovarian cancer and a germline or somatic BRCA mutation, researchers examined its overall cost-effectiveness from a US third party payer perspective. 

The data was presented at the Society of Gynecologic Oncology’s 2020 Annual meeting where the researchers concluded that “Olaparib offers a cost-effective maintenance strategy for patients.”

The researchers developed a 3-state partition survival model—including progression free, progressed disease, and death—with a one month cycle in order to estimate costs and effectiveness of olaparib vs routine surveillance for a lifetime horizon of 50 years. Using data from the originally phase 3 trial (SOLO1), piecewise models were used to extrapolate overall survival and progression free survival. 

Researchers of the study obtained treatment costs, adverse event costs, and medical costs associated with health states from publicly available databases, SOLO1, and real-world data.All costs were adjusted to inflated 2018 US dollars. Incremental costs per quality-adjusted life-year (QALY) and life-year (LY) gained were estimated (discounted at 3.0% per annum). One-way deterministic and probabilistic sensitivity (PSA) analyses were conducted.

When observing the data from the examined lifetime horizon period:

• Olaparib was associated with an additional 3.63 LYs and 2.93 QALYs, and an incremental total cost of $152,545 versus routine surveillance;  
• Incremental cost per LY gained and per QALY gained for olaparib was $42,032 and $51,986, respectively; and
• The incremental cost-effectiveness ratios remained below $100,000 across a range of inputs and scenarios. 
• The probability sensitivity anaylis showed that the probability of olaparib being cost-effective at an $100,000 per QALY threshold was 99%. 

“Compared to routine surveillance, olaparib is predicted to increase both the LYs and QALYs of patients with advanced ovarian cancer, at an overall cost that yields incremental cost-effectiveness ratios below a $100,000 threshold,” concluded researchers. —Edan Stanley