Economic evaluation of new targeted therapies for the first-line treatment of patients with metastatic renal cell carcinoma

BJU Int. 2011 Sep;108(5):665-72. doi: 10.1111/j.1464-410X.2010.09957.x. Epub 2011 Jan 25.

Abstract

Objective: • To assess the economic value of targeted therapies as first-line metastatic renal cell carcinoma (mRCC) treatment in the US and Sweden by indirect comparison of survival data.

Methods: • A Markov model simulated disease progression, adverse events and survival with sunitinib vs sorafenib in the US and bevacizumab plus interferon-α (IFN-α) in both countries. • Results, in life-years (LYs), progression-free LYs (PFLYs), quality-adjusted LYs (QALYs) gained and treatment costs (2008 USD) were obtained through deterministic and probabilistic analyses over the patient's lifetime.

Results: • Sunitinib was more effective and less costly than sorafenib (gains of 0.52 PFLYs, 0.16 LYs and 0.17 QALYs and savings/patient of $13,576 in the US) and bevacizumab plus IFN-α (gains of 0.19 PFLYs, 0.23 LYs and 0.16 QALYs in both countries and savings/patient of $67,798 and $47,264 in the US and Sweden, respectively). • Results were most influenced by hazard ratios for progression-free and overall survival and treatment costs, making results generalizable across other countries if relative costs were to fall within the ranges of those in the US and Sweden.

Conclusion: • The present analyses suggest that first-line mRCC treatment with sunitinib is a cost-effective alternative to sorafenib and bevacizumab plus IFN-α.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / economics
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / economics*
  • Antineoplastic Agents / therapeutic use*
  • Benzenesulfonates / economics
  • Benzenesulfonates / therapeutic use
  • Bevacizumab
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / economics*
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / secondary
  • Cost-Benefit Analysis
  • Disease Progression
  • Drug Costs
  • Female
  • Humans
  • Indoles / economics
  • Indoles / therapeutic use
  • Interferon-alpha / economics
  • Interferon-alpha / therapeutic use
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / economics*
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Male
  • Markov Chains
  • Molecular Targeted Therapy / economics*
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds
  • Pyridines / economics
  • Pyridines / therapeutic use
  • Pyrroles / economics
  • Pyrroles / therapeutic use
  • Quality-Adjusted Life Years
  • Sorafenib
  • Sunitinib
  • Sweden
  • United States

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Benzenesulfonates
  • Indoles
  • Interferon-alpha
  • Phenylurea Compounds
  • Pyridines
  • Pyrroles
  • Niacinamide
  • Bevacizumab
  • Sorafenib
  • Sunitinib