PURPOSE: To assess the economic value of sunitinib as first-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.
Written by:
Calvo Aller E, Maroto P, Kreif N, González Larriba JL, López-Brea M, Castellano D, Martí B, Díaz Cerezo S. Are you the author?
START Madrid, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Norte Sanchinarro, Spain.
Reference: Clin Transl Oncol. 2011 Dec;13(12):869-77.
doi: 10.1007/s12094-011-0748-0
PubMed Abstract
PMID: 22126730
UroToday.com Renal Cancer Section
