| Summary: | Background: Androgen deprivation therapy (ADT) has known adverse effects (AEs). Intermittent (INT) ADT may reduce AEs, improve quality of life, and lower costs compared to continuous (CONT) treatment. Objective: To evaluate the cost-effectiveness of INT vs CONT ADT in men with advanced prostate cancer. Methods: A lifetime Markov individual simulation model was developed to evaluate the incremental cost per quality adjusted life month (QALM) of INT vs CONT ADT. Results: INT dominated CONT ADT (mean total costs $94,460 vs $109,431; mean total QALMs 47.0 vs 46.4). INT ADT resulted in less time on therapy (22.4 vs 56.8 months), fewer hip fractures (0.080 vs 0.093 per patient), and fewer total cases of sexual dysfunction (72.5% vs 87.0% of patients) and cardiovascular disease (38.7% vs 44.6% of patients). Conclusions: These results suggest INT ADT is cost-effective compared to CONT ADT however, differences were small. Additional research is required to confirm these findings.
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