Cost-effectiveness evaluation of sunitinib as first-line targeted therapy for metastatic renal cell carcinoma in Spain
Clin. transl. oncol. (Print)
; 13(12): 869-877, dic. 2011. tab, ilus
Article
in English
| IBECS
| ID: ibc-125995
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
INTRODUCTION Sunitinib, an oral, multitargeted receptor tyrosine kinase inhibitor, delays disease progression, with a median overall survival (OS) of more than 2 years, improves quality of life and is becoming the first-line standard of care for metastatic renal carcinoma (mRCC). PURPOSE To assess the economic value of sunitinib as fi rst-line therapy in mRCC within the Spanish healthcare system. METHODS An adapted Markov model with a 10-year time horizon was used to analyse the cost effectiveness of sunitinib vs. sorafenib (SFN) and bevacizumab/interferon-α (BEV/IFN) as first-line mRCC therapy from the Spanish third-party payer perspective. Progression-free survival (PFS) and OS data from sunitinib, SFN and BEV/IFN pivotal trials were extrapolated to project survival and costs in 6-week cycles. Results, in progression-free life-years (PFLY), life years (LY) and quality-adjusted life-years (QALY) gained, expressed as incremental cost-effectiveness ratios (ICER) with costs and benefits discounted annually at 3%, were obtained using deterministic and probabilistic analyses. RESULTS Sunitinib was more effective and less costly than both SFN (gains of 0.52 PFLY, 0.16 LY, 0.17 QALY) and BEV/IFN (gains of 0.19 PFLY, 0.23 LY, 0.16 QALY) with average cost savings/patients of 1,124 and 23,218, respectively. Using a willingness-to-pay (WTP) threshold of 50,000/QALY, sunitinib achieved an incremental net benefit (INB) of 9,717 and 31,211 compared with SFN and BEV/IFN, respectively. At this WTP, the probability of sunitinib providing the highest INB was 75%. CONCLUSION Our analysis suggests that sunitinib is a costeffective alternative to other targeted therapies as first-line mRCC therapy in the Spanish healthcare setting (AU)
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Collection:
National databases
/
Spain
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 4: Health financing
Database:
IBECS
Main subject:
Pyrroles
/
Carcinoma, Renal Cell
/
Clinical Trials as Topic
/
Interferon-alpha
/
Models, Economic
/
Angiogenesis Inhibitors
/
Indoles
/
Kidney Neoplasms
Type of study:
Evaluation study
/
Health economic evaluation
/
Prognostic study
Aspects:
Patient-preference
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Clin. transl. oncol. (Print)
Year:
2011
Document type:
Article
Institution/Affiliation country:
Hospital Clínico San Carlos/Spain
/
Hospital Universitario 12 de Octubre/Spain
/
Hospital Universitario Madrid Norte Sanchinarro/Spain
/
Hospital Universitario Marqués de Valdecilla/Spain
/
Hospital de Santa Creu i Sant Pau/Spain
/
Pfizer España/Spain
/
United Biosource Corporation/UK