Woods BS Sideris E Sydes MR Gannon MR Parmar MKB Alzouebi M Attard G Birtle AJ Brock S Cathomas R Chakraborti PR Cook A Cross WR Dearnaley DP Gale J Gibbs S Graham JD Hughes R Jones RJ Laing R Mason MD Matheson D McLaren DB Millman R O'Sullivan JM Parikh O Parker CC Peedell C Protheroe A Ritchie AWS Robinson A Russell JM Simms MS Srihari NN Srinivasan R Staffurth JN Sundar S Thalmann GN Tolan S Tran ATH Tsang D Wagstaff J James ND Sculpher MJ 2018 BACKGROUND Results from large randomised controlled trials have shown that adding docetaxel to the standard of care (SOC) for men initiating hormone therapy for prostate cancer (PC) prolongs survival for those with metastatic disease and prolongs failure-free survival for those without. To date there has been no formal assessment of whether funding docetaxel in this setting represents an appropriate use of UK National Health Service (NHS) resources. OBJECTIVE To assess whether administering docetaxel to men with PC starting long-term hormone therapy is cost-effective in a UK setting. DESIGN, SETTING, AND PARTICIPANTS We modelled health outcomes and costs in the UK NHS using data collected within the STAMPEDE trial, which enrolled men with high-risk, locally advanced metastatic or recurrent PC starting first-line hormone therapy. INTERVENTION SOC was hormone therapy for ≥2 yr and radiotherapy in some patients. Docetaxel (75mg/m2) was administered alongside SOC for six three-weekly cycles. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The model generated lifetime predictions of costs, changes in survival duration, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). RESULTS AND LIMITATIONS The model predicted that docetaxel would extend survival (discounted quality-adjusted survival) by 0.89 yr (0.51) for metastatic PC and 0.78 yr (0.39) for nonmetastatic PC, and would be cost-effective in metastatic PC (ICER £5514/QALY vs SOC) and nonmetastatic PC (higher QALYs, lower costs vs SOC). Docetaxel remained cost-effective in nonmetastatic PC when the assumption of no survival advantage was modelled. CONCLUSIONS Docetaxel is cost-effective among patients with nonmetastatic and metastatic PC in a UK setting. Clinicians should consider whether the evidence is now sufficiently compelling to support docetaxel use in patients with nonmetastatic PC, as the opportunity to offer docetaxel at hormone therapy initiation will be missed for some patients by the time more mature survival data are available. PATIENT SUMMARY Starting docetaxel chemotherapy alongside hormone therapy represents a good use of UK National Health Service resources for patients with prostate cancer that is high risk or has spread to other parts of the body. https://sonar.ch/global/documents/185357 eng info:eu-repo/semantics/altIdentifier/doi/10.1016/j.euo.2018.06.004 info:eu-repo/semantics/altIdentifier/pmid/31158087 European urology oncology. - 2018 Cost-effectiveness analysis Docetaxel Prostate cancer Aged Antineoplastic Combined Chemotherapy Protocols Cost-Benefit Analysis Docetaxel Humans Male Middle Aged Neoplasm Recurrence, Local Prognosis Prostatic Neoplasms Quality-Adjusted Life Years Standard of Care United Kingdom Addition of Docetaxel to First-line Long-term Hormone Therapy in Prostate Cancer (STAMPEDE): Modelling to Estimate Long-term Survival, Quality-adjusted Survival, and Cost-effectiveness. http://purl.org/coar/resource_type/c_6501