# Application of the ASCO value framework to evaluate the clinical and economic value of enzalutamide and apalutamide in the early stages of prostate cancer in Colombia

## TL;DR

This study compares the clinical and economic value of two prostate cancer treatments in Colombia using a standardized framework.

## Contribution

The paper applies the ASCO value framework to evaluate two antiandrogens in specific prostate cancer stages within the Colombian healthcare context.

## Key findings

- Enzalutamide provided higher net health benefits than apalutamide in both nmCRPC and mHSPC stages.
- Enzalutamide had lower costs per net health benefit point compared to apalutamide in both cancer stages.
- The ASCO value framework highlights enzalutamide as a more cost-effective option in Colombia.

## Abstract

Prostate cancer has increased in recent years, increasing the costs associated with its treatment. Second-generation oral antiandrogens have emerged as an attractive therapeutic option.

To compare the health value provided by enzalutamide and apalutamide, by evaluating two stages of prostate cancer: non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC).

To establish, through the American Society of Clinical Oncology (ASCO) value framework, a contrast between two technologies in two stages of prostate cancer. The monthly cost of the two technologies was calculated according to the current price regulation norm in Colombia.

Enzalutamide showed a higher net health benefit score compared to apalutamide for both nmCRPC (48.33 versus 33.46) and mHSPC (52.0 versus 40.75). The cost per net health benefit point for the nmCRPC stage was $214,723 Colombian Pesos (COP) ($54.84 USD) with enzalutamide compared to $291,925 COP ($74.56 USD) with apalutamide, and for the mHSPC stage was $199,692 COP ($51.00 USD) with enzalutamide and $239,701 COP ($61.22 USD) with apalutamide.

After comparing enzalutamide versus apalutamide in the nmCRPC and mHSPC stages through the ASCO value framework, enzalutamide showed a more prominent net clinical benefit and a lower investment per point awarded.