Cost-Effectiveness Analysis of Olaparib and Niraparib as Maintenance Therapy for Women with Recurrent Platinum-Sensitive Ovarian Cancer

Olaparib was more cost-effective, compared with niraparib, as maintenance therapy for patients with recurrent platinum-sensitive ovarian cancer, as determined by a model-based analysis.

A model-based analysis evaluated the cost-effectiveness of the poly (ADP-ribose) polymerase (PARP) inhibitors, olaparib and niraparib, as maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer; findings of this analysis were published in Expert Review of Pharmacoeconomics and Outcomes Research.

The study utilized a decision analysis model to compare the costs and effectiveness of olaparib and niraparib versus placebo for patients with ovarian cancer with or without germline BRCA mutations (gBRCAm). The 2020 National Health Insurance Administration reimbursement price list was used to estimate resource use and associated costs. Clinical effectiveness was measured in progression-free survival per life-years (PFS-LY) based on results of the clinical trials, SOLO2/ENHOT-Ov21 and ENGOT-OV16/NOVA. The incremental cost-effectiveness ratio (ICER) was estimated from a single-payer perspective.

The analysis showed that, in the base case, olaparib was more cost-effective compared with niraparib or placebo. Compared with placebo, the ICER for olaparib was lower (New Taiwan dollars [NT]$1,804,785 per PFS-LY) than for niraparib (NT$2,340,265 per PFS-LY). The ICER was impacted by PFS and the total resource use cost of the niraparib regimen for patients without gBRCA, as assessed by tornado analysis (a type of sensitivity analysis that provides a graphical representation of the degree to which the result is sensitive to the specified independent variables). For both drugs, the ICERs in patients with a gBRCA mutation were lower than those in patients without a gBRCA mutation. Probabilistic sensitivity analysis estimated that olaparib was more cost-effective than niraparib, based on the willingness-to-pay threshold of NT$2,602,404 per PFS-LY gained.

Based on results of this study, the investigators concluded that olaparib was more cost-effective than niraparib as maintenance therapy for patients with recurrent platinum-sensitive ovarian cancer.

Source: Leung JH, Lang HC, Wang SY, Lo HF, Chan ALF. Cost-effectiveness analysis of olaparib and niraparib as maintenance therapy for women with recurrent platinum-sensitive ovarian cancer. Expert Rev Pharmacoecon Outcomes Res. 2021 Aug 6;1-8. doi: 10.1080/14737167.2021.1954506. Online ahead of print.