Conclusion

The CEACs summarise this uncertainty across different cost-effectiveness thresholds.

At a cost-effectiveness threshold of 3× GDP per capita, ARPI combine ADT had a 62.0% probability of being the most cost-effective option, while Chemotherapy combine ADT strategies had negligible probabilities (0.94%).

At a higher threshold of 10× GDP per capita, ARPI combine ADT remains the most cost-effective option.

ADT: Androgen Deprivation Therapy; ARPI, androgen receptor pathway inhibitor; PARPi, poly(ADP-ribose) polymerase inhibitors. QALY, Quality-Adjusted Life Year; GDP, Gross Domestic Product.

Assumption​:

A baseline prevalent mHSPC patients of 2200 in 2024 at model entry;​

• Forecasting number of incident patients: Annual incidence of mHSPC patients entering the budget impact model for 2025–2029 is projected to be 762, 788, 815, 841, and 867, based on ARIMA model estimates derived from yearly incident cases between 2000 and 2024.

• Market share: ​
• Scenario 1 (100% uptake per strategy): each treatment strategy is assumed as full uptake in the target population;​
• Scenario 2 (equal market share): Equal share among treatments.​

Conclusion

• Overall expenditure shows a sharp upward trajectory over time.
• In the equal-share scenario, the total budget increases from approximately HK$3.39B in Year 1 to HK$6.37B in Year 5.
• This reflects the significant long-term financial burden associated with treatment intensification in metastatic prostate cancer

ADT: Androgen Deprivation Therapy; ARPI, androgen receptor pathway inhibitor; PARPi, poly(ADP-ribose) polymerase inhibitors.