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    Real-world incidence and burden of adverse events among non-metastatic prostate cancer patients treated with secondary hormonal therapies following androgen deprivation therapy

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    Author
    Shah, A.
    Shah, R.
    Hussain, A.
    Date
    2020
    Journal
    Journal of Medical Economics
    Publisher
    Taylor and Francis Ltd
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.1080/13696998.2019.1705313
    Abstract
    Aims: To describe the incidence and identify prognostic factors of central nervous system (CNS) adverse events (AEs) and any AEs (CNS, skin rash, or fracture) and evaluate the healthcare resource utilization (HCRU), direct medical costs, and therapy discontinuation associated with these AEs among non-metastatic prostate cancer (nmPC) patients who received secondary hormone therapies. Methods and results: nmPC patients who had initiated secondary hormonal therapy with enzalutamide, bicalutamide, or abiraterone ≥1 year after androgen deprivation therapy (ADT) were identified in the MarketScan database. Survival analyses were used to describe the incidence of CNS or any AEs. Annual HCRU and costs were compared across patient groups (CNS AE vs no CNS AE; any AE vs no AE) using propensity score weighted generalized linear models. Multivariate Cox proportional hazards models were used to identify AE predictors and compare risks of discontinuation. Results: The analysis included 532 patients who initiated secondary hormonal therapies, among whom 201 (38%) and 244 (46%) experienced a CNS AE and any AE, respectively. Median times to CNS AE and any AE from therapy initiation were 17.90 and 11.00 months, respectively. Predictors of any AE were any AE in the baseline period (≤6 months before starting therapy), Charlson Comorbidity Index (CCI) score (1 vs 0), surgical castration, and older age. Predictors of CNS AEs were CNS AE in the baseline period and CCI score (1 vs 0). CNS and any AEs were associated with significantly higher HCRU. CNS AEs were associated with significantly higher incremental total medical costs ($18,522). CNS AEs and any AEs significantly increased therapy discontinuation risk by 48% and 38%, respectively. Conclusions: AEs increase the economic burden and therapy discontinuation among nmPC patients receiving secondary hormonal therapies subsequent to ADTs. These patients should be carefully evaluated for AEs to reduce therapy discontinuation, HCRU, and direct medical costs. Copyright 2020, The Author(s).
    Sponsors
    This research study was funded by Bayer Healthcare Pharmaceuticals.
    Keyword
    abiraterone acetate
    advanced prostate cancer
    adverse events
    bicalutamide
    discontinuation
    Enzalutamide
    healthcare costs
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85078611955&doi=10.1080%2f13696998.2019.1705313&partnerID=40&md5=5e9c8c4e6426511218a8ce24ff80ecb4; http://hdl.handle.net/10713/11703
    ae974a485f413a2113503eed53cd6c53
    10.1080/13696998.2019.1705313
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