Cost‐effectiveness analysis of additional docetaxel for metastatic hormone‐sensitive prostate cancer treated with androgen‐deprivation therapy from a Chinese perspective

The E3805 ( CHAARTED ) study found that docetaxel combined with androgen‐deprivation therapy ( ADT ) significantly improved overall survival of patients with metastatic hormone‐sensitive prostate cancer. This study aims to determine whether docetaxel combined with ADT is a cost‐effective strategy for advanced prostate cancer in China. According to the E3805 study, two groups (docetaxel + ADT and ADT alone) and three health states [progression‐free survival ( PFS ), progressive disease ( PD ) and death] were analysed in a Markov model. All medical costs were calculated from the Chinese societal perspective. Quality‐adjusted life year ( QALY ) and incremental cost‐effectiveness ratios ( ICER s) were applied as the primary outcome. Overall, the addition of docetaxel was estimated to increase the cost by $12 816.93, with a gain of 0.48 QALY . Additionally, for patients with high‐volume disease, the increased cost and effectiveness were $14 627.75 and 0.69 QALY s in docetaxel + ADT group versus the ADT alone group, and the ICER was $21 199.63 per QALY . These ICER s are far more than the commonly accepted willingness‐to‐pay ( WTP ) threshold of $20 301 per QALY in China. In spite of longer survival time, docetaxel combined with ADT is not a recommended cost‐effective treatment for metastatic hormone‐sensitive prostate cancer in the Chinese setting.