A cost-effectiveness analysis of sunitinib in patients with metastatic renal cell carcinoma intolerant to or experiencing disease progression on immunotherapy: perspective of the Spanish National Health System.

Abstract

AIM:

To investigate the cost-effectiveness of sunitinib (50 mg/day, schedule 4/2) vs. best supportive care (BSC) in patients with cytokine-refractory metastatic renal cell carcinoma (mRCC), from the perspective of the Spanish National Health Service.

MATERIAL AND METHODS:

A Markov model compared the cost-effectiveness (taking into account drugs; medical visits; laboratory tests; X-rays; terminal care; adverse event management) of sunitinib and BSC across three disease states: no progression, survival with progression and death from mRCC or other causes.

RESULTS:

The monthly incremental cost-effectiveness ratio (ICER) values for sunitinib treatment were €6073/progression-free survival month, €25,199/life years and €34,196/quality-adjusted life years (QALY) gained. In 95% of cases, the ICER/QALY values were below the accepted €45,000/QALY threshold. Efficacy and cost of sunitinib had the greatest impact on cost-effectiveness.

CONCLUSION:

Sunitinib has a good cost-effectiveness profile in mRCC. The cost per life year and QALY gained is affordable according to current effectiveness thresholds in developed countries.

• Authors: L Paz-Ares, J G del Muro, E Grande, S Díaz
• Journal: Journal of clinical pharmacy and therapeutics (J Clin Pharm Ther) Vol. 35 Issue 4 Pg. 429-38 (Aug 2010) ISSN: 1365-2710 [Electronic] England
• PMID: 20831545 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Cytokines
• Indoles
• Protein Kinase Inhibitors
• Pyrroles
• Sunitinib

Topics

• Angiogenesis Inhibitors (administration & dosage, economics, therapeutic use)
• Carcinoma, Renal Cell (drug therapy, economics, secondary)
• Cost-Benefit Analysis
• Cytokines (therapeutic use)
• Disease Progression
• Disease-Free Survival
• Drug Costs
• Drug Resistance, Neoplasm
• Female
• Health Care Costs
• Humans
• Immunotherapy
• Indoles (administration & dosage, economics, therapeutic use)
• Kidney Neoplasms (drug therapy, economics, pathology)
• Male
• Markov Chains
• Middle Aged
• Models, Economic
• Palliative Care (economics)
• Protein Kinase Inhibitors (administration & dosage, economics, therapeutic use)
• Pyrroles (administration & dosage, economics, therapeutic use)
• Quality-Adjusted Life Years
• Spain
• Sunitinib