Table 3.

Treatment Costs in Patients With CRPC for 30-Day Period (oral drugs) or One Infusion/Cycle (parenteral drugs)

Drug Name	Approval Date	Large Group Commercial Insurance Rate ($)*	Medicare Rate ($)*
Abiraterone acetate	2011	5,171.90	6,409.11
Bicalutamide	1995	Generic, 82; brand, 520	Generic, 28; brand, 527
Cabazitaxel†	2010	11,233.78	12,806.06
Degarelix	2008	445.53	536.75
Docetaxel†	1999	Brand (pregeneric), 3,006.19	Generic, 681.67
Enzalutamide	2012	‡	7,906.34
Flutamide	1989	79.65	125.80
Goserelin acetate	1995	596.00	210.32
Ketoconazole	1999	66.52	19.22
Leuprolide acetate	1998	356.00	202.84
Mitoxantrone†	1987	615.63	203.96
Nilutamide	1996	464.13	4,201.38
Prednisone	1974	3.75	6.50
Radium-223	2013	12,455.00‡	12,455.00‡
Sipuleucel-T§	2010	40,670.42	34,672.58

Abbreviations: CRPC, castration-resistant metastatic prostate cancer; MSKCC, Memorial Sloan Kettering Cancer Center.

^*Large group commercial rates were calculated using health care claims from Truven Health Analytics MarketScan Commercial Claims and Encounters database.⁵⁹ Calculation is based on total reimbursement for services rendered based on most common supply of each product (30 days for most oral medications or per infusion for injectable medications).

^†Indicates regimen of every 3 weeks (sipuleucel-T and radium-223 are limited-course therapies). Prices represent median dollars paid by both patients and insurers between 2010 and 2011 for each product use. Medicare rates were calculated using methodology developed at Center for Health Policy and Outcomes at MSKCC,⁶⁰ described by Bach et al.⁶¹ For each oral medication, 2013 full drug price was identified using the Medicare Plan Finder tool. For each infused medication, dosage for original US Food and Drug Administration–approved indication was used, and reimbursement rate was taken from fourth-quarter 2013 average sales price files. Medicare rates are standardized to monthly price. Price discrepancies between commercial insurance and Medicare may represent differences in price between periods (commercial, 2010 to 2011; Medicare, 2013) or impact of generic entry on price (eg, docetaxel). For infused medications, differences between per-use and monthly price estimates may be evident, particularly for drugs administered less frequently than every month (eg, goserelin acetate). Some products are administered for limited set time periods (eg, sipuleucel-T, radium-223), and prices represent fraction of total course cost during abbreviated period.

^‡Product not used during period when data were available. Prices for radium-223 were obtained from MSKCC Web site, which were estimated from media reports at time of last update.

^§Same as † footnote, but indicates regimen of every 2 weeks.