Cost Comparison of Adverse Event Management among Breast and Ovarian Cancer Patients Treated with Poly (ADP-ribose) Polymerase Inhibitors: Analysis Based on Phase 3 Clinical Trials

Background: The economic impact of adverse events (AEs) for poly (ADP-ribose) polymerase inhibitors (PARPis) in ovarian or breast cancer has not been widely evaluated. Objective: Compare PARPi-related AE management costs from a US payer perspective. Methods: The frequency of treatment-related grade 3–4 AEs was obtained from published clinical trials of PARPis for the treatment of advanced ovarian cancer (AOC), platinum-sensitive recurrent ovarian cancer (PSROC), and metastatic breast cancer (MBC). AE management costs per patient (2020 USD) per treatment course were calculated by multiplying the AE unit costs by the frequency of AEs for each arm of each trial. Sensitivity analyses were conducted according to the lower and upper limits of the 95% confidence interval for AE rates and unit costs, respectively. Scenarios were also performed to explore the uncertainty of outcomes. Results: Total AE management costs in AOC were: $3904, olaparib; $5595, olaparib plus bevacizumab; and $12,215, niraparib. In PSROC, total costs were: $3894, olaparib; $6001, rucaparib; and $11,492, niraparib, and in MBC: $3574, olaparib; and $9489, talazoparib. Hematological toxicities were the key drivers of AE management costs for PARPis. Conclusions: The main AEs among PARPis were hematological. Olaparib was associated with lower AE costs compared to other PARPis.