Chiang CL, et al. - Via the first cost-effectiveness analysis in Hong Kong to study these combinations, experts assessed the economic value of androgen-deprivation therapy (ADT) + abiraterone acetate (AA) vs ADT + docetaxel (D) using a deterministic Markov model. In comparison to ADT-alone, integrating simulations with probabilistic sensitivity analysis, ADT + D returned 0.79 quality-adjusted life year (QALY) with an incremental cost-effectiveness ratio (ICER) of US$14,397/QALY ($7824–22,632). ADT + AA earned 0.79 QALY but with an ICER of $361,439/QALY ($260,615–599,683) vs ADT + D. ADT + D was observed as more cost-effective in all simulations, recognizing three times of gross domestic product per capita as the willingness-to-pay threshold, whereas, only when the cost of AA was lowered by at least 63%, ADT + AA was found more cost-effective than ADT + D. When equivalent effectiveness as the standard dosage (1,000 mg) was seen, the low-dose AA (250 mg) strategy was recognized as possibly cost-effective. In metastatic castration-sensitive prostate cancer patients in developed economies, ADT + D was revealed to be a more cost-effective strategy vs ADT + AA. In contrast to D, the addition of AA considerably enhanced QALY but at an significant cost.