Cost-effectiveness analysis of triptorelin therapy for patients with prostate cancer in state healthcare system of the Russian Federation

Objective. Cost-effectiveness analysis of triptorelin and other luteinizing hormone releasing hormone (LHRH) agonists in the treatment of adults with prostate cancer. Material and methods. Cost-effectiveness analysis included costs of drugs and treatment of adverse events, budget impact analysis (BIA) and sensitivity analysis. Three LHRH agonists were selected (goserelin, leuprorelin, triptorelin). Results. The most efficient is triptorelin (35.870.01 rubles for a 9-month course of drug therapy). The highest cost is associated with leuprorelin therapy (54.945.51 rubles). Analysis of costs for AE relief showed that the lowest costs were associated with triptorelin (RUB 971.21), the highest — with goserelin (RUB 3.448.24). Thus, the highest total costs were associated with leuprorelin (RUB 57.857.15), the lowest — with triptorelin (RUB 36.841.22). The ratio of costs to probability of achieving serum testosterone<10 ng/dL after 9-month therapy was RUB 41.163.38 for triptorelin, RUB 69.456.36 for leuprorelin, and RUB 132.810.02 for goserelin. Triptorelin turned out to be strictly preferable compared to leuprorelin and goserelin due to higher efficiency and lower costs. According to BIA data, widespread triptorelin and leuprorelin therapy will decrease burden on healthcare system in the Russian Federation. Savings amount to 1 256 927.88 rubles for population of 1000 patients. Sensitivity analysis revealed that triptorelin retains its advantages even in deviations of baseline clinically significant parameters by ±10%. Conclusion. Compared to other LHRH agonists, triptorelin is cost-effective strategy for care in patients with prostate cancer in the Russian Federation.