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# Enzalutamide in prostate cancer costs AUD$835,580 per QALY in ENZAMET trial analysis
- URL: https://www.coios.me/enzalutamide-in-prostate-cancer-costs-aud-835-580-per-qaly/
- Published: 2026-10-18T11:36:59.000Z
- Updated: 2026-10-18T12:15:57.000Z
- Description: Adding enzalutamide in the ENZAMET trial cost AUD$835,580 per QALY gained, far above the AUD$50,000 threshold.
- Author: Daniel Ryan
- Tags: Data, models and systems, Value in health, Cancer, Innovation in treatment, Australia, #peer-reviewed, #new, #item, #source-2026-10, #score-82

A within-trial cost-effectiveness analysis of ENZAMET, which randomised 1125 men with metastatic hormone-sensitive prostate cancer. Men received enzalutamide or a conventional non-steroidal antiandrogen alongside testosterone suppression, and were followed 60 months. Costs and quality of life came from trial records, EQ-5D-5L questionnaires and linked Medicare claims. Enzalutamide cost an extra AUD$127,262 per patient, gaining 0.24 life-years and 0.15 QALYs, or AUD$835,580 per QALY. At AUD$50,000 per QALY it had a 6% probability of being cost-effective; AUD$6.73 per tablet would meet the threshold. Primary care costs covered only consenting Australian participants, and costs after progression were not collected.

*Why it is interesting: A rare cost-effectiveness analysis using observed trial and claims data rather than a model. Musculoskeletal medicine claims were higher on enzalutamide, though costs were not attributed to falls or fractures.*

Source

[eClinicalMedicine, 17 October 2026](https://doi.org/10.1016/j.eclinm.2026.104207?ref=coios.me)

Paper

Cost-effectiveness of adding enzalutamide vs standard non-steroidal antiandrogen drugs for patients with metastatic hormone-sensitive prostate cancer undergoing standard first-line therapy: a within-trial, secondary end-point analysis of the ENZAMET phase 3, international randomized trial (ANZUP 1304)

Authors

Law CK, Stockler MR, Martin AJ, Davis ID, Sweeney CJ, Morton RL

DOI

10.1016/j.eclinm.2026.104207

Full text

[Open copy](https://pmc.ncbi.nlm.nih.gov/articles/PMC13673054/?ref=coios.me) (open-access copy, PubMed Central)

Type

Peer-reviewed article

Design

Within-trial cost-effectiveness/cost-utility analysis of the ENZAMET open-label phase 3 RCT (ANZUP 1304), Australian health system perspective, trial records linked to Medicare claims and EQ-5D-5L questionnaires, 68-month median follow-up, data cut-off January 2022, costs in 2023 AUD

Verdict

New finding

Driver

[Value in health](https://www.coios.me/d-health-economics/)

Driver

[Cancer](https://www.coios.me/d-cancer/)

Driver

[Innovation in treatment](https://www.coios.me/d-treatment-innovation/)