NDLI: Economic evaluation of sunitinib malate in second-line treatment of metastatic renal cell carcinoma in Finland.

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Economic evaluation of sunitinib malate in second-line treatment of metastatic renal cell carcinoma in Finland.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Purmonen, Timo Martikainen, Janne A. Soini, Erkki J. O. Kataja, Vesa Vuorinen, Riikka-Liisa Kellokumpu-Lehtinen, Pirkko-Liisa
Spatial Coverage	Finland
Description	Country affiliation: Finland Author Affiliation: Purmonen T ( Centre for Pharmaceutical Policy and Economics, Department of Social Pharmacy, University of Kuopio, Kuopio, Finland. Timo.Purmonen@uku.fi)
Abstract	BACKGROUND: Cytokine therapy is currently used as first-line treatment of metastatic renal cell carcinoma (mRCC). Until recently, treatments with proven efficacy after the failure of first-line cytokine therapy were not available. In recent clinical trials, sunitinib has been associated with good response rates in patients with mRCC. OBJECTIVE: The aim of this study was to analyze the cost-effectiveness of sunitinib as second-line therapy for cytokine-refractory mRCC compared with current routine clinical practice in Finland (ie, best supportive care [BSC], including palliative biochemotherapy). METHODS: A probabilistic decision-analytic model was developed to estimate the cost-effectiveness of sunitinib. Data were gathered from clinical trials, literature sources, and expert opinions, as well as from a local sample (n = 39) from 2 university hospitals in Finland. Clinical experts treating patients with mRCC in Finland provided the information on care practices of prescribing sunitinib. The analysis was conducted from the perspective of the health care payer in Finland. RESULTS: According to estimated incremental cost-effectiveness ratios (ICERs), 1 progression-free month gained cost euro4802 (2005 Euros); 1 life-year gained cost euro30,831; and 1 quality-adjusted life-year (QALY) gained cost euro43,698, compared with BSC, in the treatment of mRCC. The expected mean cost in BSC was euro5543. When parameter uncertainty was considered, the probability of sunitinib being the more cost-effective choice of treatment was ~70% at the willingness-to-pay level of euro45,000/QALY gained. CONCLUSIONS: Based on the results of this cost-effectiveness analysis, sunitinib is potentially cost-effective as a second-line treatment of mRCC compared with the treatment currently practiced in Finnish hospitals. The ICER (euro/QALY gained) obtained in the present study was less than the value considered suitable for novel oncology treatments.
File Format	HTM / HTML
ISSN	01492918
Issue Number	2
Volume Number	30
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2008-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Angiogenesis Inhibitors Therapeutic Use Carcinoma, Renal Cell Drug Therapy Health Care Costs Indoles Kidney Neoplasms Protein Kinase Inhibitors Pyrroles Aged Economics Mortality Secondary Cost-benefit Analysis Cytokines Decision Support Techniques Disease-free Survival Drug Costs Female Finland Epidemiology Humans Kaplan-meier Estimate Pathology Male Markov Chains Models, Economic Palliative Care Quality-adjusted Life Years Time Factors Treatment Failure Comparative Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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