Gli analoghi del GnRH nel trattamento del carcinoma prostatico: un’analisi di costo-terapia

Autori: Mauro Caruggi, Giorgio L. Colombo, Chiara Ottolini

Cost-of-treatment analysis was developed to evaluate the times required to deliver GnRH-agonists in prostate cancer treatment.

The comparison was made in Azienda Ospedaliera di Busto Arsizio, Varese. A stopwatch was used to time elements of essential processes (pharmacy preparation, administration and control) for the delivery of a single dose of GnRH-agonists, in order to build a hypothetic diagnostic and therapeutic pathway and to describe different phases, times, and costs for each formulation. Efficacy was considered equivalent between formulations.

Enantone (leuprorelin acetate) was less time consuming at the Cancer Centre. In the base-case scenario, total costs per year were € 989.85 for Enantone (leuprorelin acetate) versus € 1,129.22 for Eligard (leuprorelin acetate); € 1,170.52 for Zoladex (goserelin), € 1,077.68 for Decapeptyl (triptorelin) and € 1,252.80 for Gonapeptyl (triptorelin) respectively per year of treatment. Enantone results in cost savings ranging between 9% and 25% vs. other GnRH-agonists. Productivity loss and patient waiting time were not included in this analysis. Results were submitted to a sensitivity analysis.

Delivery of Enantone (leuprorelin acetate) in prostate cancer treatment is less resource-intensive and time-consuming than other GnRH-agonist treatments. A switch from other GnRH-agonist treatments to Enantone (leuprorelin acetate) could increase the capacity of the Day-Hospital Unit, with a consequent reduction of the patient waiting list associated to a global cost reduction. The methodology provides a quantitative measure of comparative capacity that could be used as part of future health technology assessment.

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