The ENZAMET trial has shown that adding enzalutamide to hormone therapy can help people with metastatic hormone-sensitive prostate cancer live longer and delay their cancer from progressing. Researchers have now looked at another important question: what is the cost of adding this medicine to standard of care to improve both quality and length of life (quality-adjusted life years).
This type of research is known as a cost-effectiveness analysis. It looks not only at whether a treatment works, but also at how much it costs and how much additional health and quality of life it provides or Quality-adjusted Life Years (QALYs) – an instrument that measures the value of medical treatments. This is important because healthcare systems have limited resources and need to consider how best to distribute funding across many different conditions and treatments.
Researchers analysed health, quality-of-life and healthcare information collected during the ENZAMET trial, including information from Medicare claims and patient questionnaires. They compared people who received enzalutamide with those who received the older hormone treatment used as the comparator in the trial, looking at outcomes over five years.
The analysis found that those receiving enzalutamide gained an average of around three additional months of life, as well as additional time living with a good quality of life. However, these benefits came at a substantially higher cost. Over five years, healthcare costs were around $127,000 higher per person for those receiving enzalutamide.
Based on the price of enzalutamide used in the study, the researchers concluded that it was unlikely to be considered cost-effective according to the usual Australian healthcare thresholds. However, the analysis also showed how strongly the result was influenced by the price of the medicine. At a lower purchase price of $6.73 per tablet, enzalutamide met the study’s cost-effectiveness threshold.
The researchers also found slightly higher rates of hospitalisation and use of medicines associated with muscle and bone problems among people receiving enzalutamide. This reinforces the importance of monitoring bone health, falls and fractures as people live longer with prostate cancer.
The findings don’t change the evidence that enzalutamide can provide important benefits for some with metastatic prostate cancer. Instead, they highlight a broader challenge in modern cancer care: how can effective treatments be made accessible and affordable, while ensuring healthcare resources provide the greatest possible benefit for patients and the community? To read more about the study
https://www.sciencedirect.com/science/article/pii/S2589537026004608?utm_source=chatgpt.com#abs0010
Law CK, Stockler MR, Martin AJ, Davis ID, Sweeney CJ, Morton RL. 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). eClinicalMedicine. 2026;100:104207. doi:10.1016/j.eclinm.2026.104207.