OBJECTIVE To analyze the economics of first-line androgen deprivation therapy combined with rezvilutamide and bicalutamide in the treatment of large-volume, metastatic, hormone-sensitive prostate cancer.

METHODS From the point of view of China’s health system, a three-state partition survival model of progression-free survival, disease progression and death was constructed based on CHART data and Excel 2019 for cost-utility analysis. The cycle time of the model was 4 weeks, the duration of study was lifetime, and the discount rate of cost and effect was set at 5%. The main outputs were total cost, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). Single factor sensitivity analysis and probability sensitivity analysis were carried out for the important parameters in the model.

RESULTS Baseline analysis: compared with the bicalutamide regimen, the rezvilutamide regimen resulted in an increase of 2.293 QALYs with a concurrent cost increase of 519025.32 Yuan and an ICER of 226379.14 yuan per QALY. Univariate sensitivity analysis showed that progression-free survival status utility, cost of rezvilutamide, and discount rate had significant effects on ICER. The probability sensitivity analysis showed that when the willing to pay was 3 times the gross domestic product per 2021 of China, the probability was 73.8%.

CONCLUSION The first-line treatment of high-volume, metastatic, hormone-sensitive prostate cancer with the rezvilutamide regimen is economical at a 2021 of China’s gross domestic product per capita threshold.