Including darolutamide as a treatment option for nonmetastatic castration-resistant prostate cancer (CRPC) results in a manageable budget increase that is partially offset by the toxicity costs in the first 4 years, followed by cost saving by year 5 (J Manag Care Spec Pharm. 2020;1-9. doi:10.18553/jmcp.2020.20330).
Darolutamide increases metastasis-free survival among men with nmCRPC compared with placebo but the budget impact is unknown.
“The purpose of this study is to estimate the projected budget impact of including darolutamide on a U.S. payer formulary as a treatment option for men with nmCRPC,” explained the study authors.
An economic model estimated costs associated with darolutamide and nmCRPC. The estimated budget impact of adding darolutamide was based on a comparison between a scenario in which the drug was not available and a scenario in which it was available and used to treat nmCRPC. Drug acquisition, administration, and AE costs were included in the calculations. The modeled population was based on a hypothetical 1-million-member plan over a 5-year period.
Each year, approximately 90 cases of nmCRPC were present with 46 high risk. By year 5, 332 cases were treatment-eligible and 109 were high risk. In year 1, darolutamide’s market share was 3.6% and by year 5, it increased to 18%.
In year 1, the total budget increased by $158,640 ($0.0132 per member per month [PMPM]) but decreased over time. By year 5, a cost savings of $149,240 ($0.0124 PMPM) was demonstrated because of reduced AE costs each year. The high-risk nmCRPC population showed similar results.
“The base-case model results indicate that adding darolutamide to a U.S. formulary as a therapeutic option for the treatment of nmCRPC would result in a manageable increase in the budget in the first 4 years after its introduction (2.23%, 1.49%, 0.78%, and 0.12% in years 1, 2, 3, and 4, respectively), followed by a 0.51% cost savings in year 5,” concluded the study authors.—Lisa Kuhns
