Avodart Not Cost
Effective Way to Prevent Prostate Cancer in Some Men
For average man,
dutasteride provides minimal survival benefits, reduction on
treatment-related complications does not offset the high costs
Feb. 8, 2011 –
The popular drug Avodart (dutasteride) may not be a cost-effective way
to prevent prostate cancer in men who are at elevated risk of developing
the disease, according to findings by a UT Southwestern Medical Center
researcher. Prior research has shown the drug lowered the risk of
prostate cancer over a four-year period by 22.8 percent, but questions
have remained about its cost-effectiveness.
In a study
available in the January issue of Cancer Prevention Research,
investigators found that the medication, at an annual cost of $1,400, is
impractical when compared to the marginal impact on survival and quality
of life in at-risk groups. The drug is primarily for the treatment of
enlarged prostates but also is widely prescribed for chemoprevention.
prostate cancer is the most common cancer in men, the implications of
this data are significant since there could be millions of men who would
be eligible for anti-cancer drugs," said Dr. Yair Lotan, associate
professor of urology at UT Southwestern.
instituting a chemoprevention strategy to a large population, the
utility and cost need to be well understood. Whether a medication
improves survival, how it affects quality of life, and what its
financial implications will be are all critical issues.
typically is prescribed for the lifetime of the patient, and therefore
taken daily for decades, the cost issue is particularly relevant."
study analyzed the lifetime health-related costs of the drug in patients
at greater risk of developing prostate cancer and compared them to other
factors, such as quality and length of life.
Dr. Lotan and
his colleague, Dr. Robert Svatek of UT Health Science Center at San
Antonio, used a Markov probability model to compare the lifetime cost of
taking Avodart with no therapy. They used data from a previous trial and
studies that evaluated outcomes of patients with prostate cancer,
including treatment-related complications to create the model.
outcome was measured in quality-adjusted life years (QALY), which takes
into account both quality and quantity of life.
"The study found
that Avodart was not cost-effective for chemoprevention unless and until
a strategy is developed for targeting very high-risk patients and the
cost of the drug decreases," said Dr. Lotan.
"For the average
man, the drug provides minimal survival benefits, and the reduction on
treatment-related complications does not compensate for the high costs
of every man taking the drug for many years."
Why is this
used to treat an enlarged prostate (benign prostatic hyperplasia, or BPH).
Dutasteride is in a class of medications called 5-alpha reductase
inhibitors. It works by blocking the production of a natural substance
that enlarges the prostate. This shrinks the prostate, relieves symptoms
of BPH, such as frequent and difficult urination, and decreases the
chance that surgery will be needed to treat this condition. Learn more