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Radium-223 for Patients with Castration Resistant Prostate Cancer with Bone Metastases: A Review of Clinical Effectiveness, Cost-effectiveness and Guidelines

Last updated: October 31, 2016
Project Number: RC0817-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of Ra-223 in patients with castration resistant prostate cancer with bone metastases?
  2. What is the cost effectiveness of Ra-223 in patients with castration resistant prostate cancer with bone metastases?
  3. What are the evidence-based guidelines associated with the use of Ra-223 in patients with castration resistant prostate cancer with bone metastases?

Key Message

The clinical evidence from a Phase III, double-blind, placebo-controlled trial showed that Ra-223 improved overall survival and delayed in time to first symptomatic skeletal event with an acceptable safety profile in men with bone mCRPC. The economic evaluation suggested that Ra-223 therapy was not cost-effective. All the included guidelines recommended that Ra-223 be used in symptomatic bone mCRPC without visceral metastases. One guideline, however, considered costs and recommended Ra-223 if an agreement on a discounted price of the drug was attainable.