Cost-effectiveness of sorafenib treatment in field practice for patients with hepatocellular carcinoma

被引：102

作者：

Camma, Calogero ^{[1
]}

Cabibbo, Giuseppe ^{[1
]}

Petta, Salvatore ^{[1
]}

Enea, Marco ^{[2
]}

Iavarone, Massimo ^{[3
]}

Grieco, Antonio ^{[4
]}

Gasbarrini, Antonio ^{[4
]}

Villa, Erica ^{[5
]}

Zavaglia, Claudio ^{[6
]}

Bruno, Raffaele ^{[7
]}

Colombo, Massimo ^{[3
]}

Craxi, Antonio ^{[1
]}

机构：

[1] Univ Palermo, Sez Gastroenterol, DIBIMIS, I-90127 Palermo, Italy

[2] Univ Palermo, Dipartimento Sci Stat & Matemat S Vianelli, I-90127 Palermo, Italy

[3] Univ Milan, Fdn IRCCS Ca Granda Maggiore Hosp, Migliavacca Ctr Liver Dis, Div Gastroenterol 1, Milan, Italy

[4] Univ Cattolica Sacro Cuore, Sch Med, Inst Internal Med, I-00168 Rome, Italy

[5] Univ Modena & Reggio Emilia, Dipartimento Med Interna, UO Gastroenterol, Modena, Italy

[6] Azienda Osped Niguarda CaGranda, Milan, Italy

[7] Univ Pavia, Fdn IRCCS San Matteo Hosp, Div Infect & Trop Dis, I-27100 Pavia, Italy

来源：

HEPATOLOGY | 2013年 / 57卷 / 03期

关键词：

CLINICAL-TRIALS; DESIGN;

D O I：

10.1002/hep.26221

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The purpose was to assess the cost-effectiveness of sorafenib in the treatment of hepatocellular carcinoma (HCC) patients incorporating current prices and the results of the recent published field practice SOraFenib Italian Assessment (SOFIA) study. We created a Markov Decision Model to evaluate, in a hypothetical cohort of Caucasian male patients, aged 67 years with Barcelona Clinic Liver Cancer (BCLC) C HCC, or BCLC B HCC who were unfit or failed to respond to locoregional therapies, well compensated cirrhosis, and with performance status 0-1 according to Eastern Cooperative Oncology Group (ECOG), the cost-effectiveness of the following strategies: (1) full or dose-adjusted sorafenib for BCLC B and C patients together; (2) full or dose-adjusted sorafenib for BCLC B patients; (3) full or dose-adjusted sorafenib for BCLC C patients. Outcomes include quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratio (ICER). In the base-case analysis dose-adjusted sorafenib was the most effective of the evaluated strategies. For dose-adjusted sorafenib, QALY was 0.44 for BCLC B and C patients together, 0.44 for BCLC C patients, and 0.38 for BCLC B patients. The ICER of dose-adjusted sorafenib compared with BSC was Euro34,534 per QALY gained for BCLC B and C patients together, Euro27,916 per QALY gained for BCLC C patients, and Euro54,881 per QALY gained for BCLC B patients. Results were sensitive to BSC survival rate, and sorafenib treatment duration. Conclusion: In daily practice dose-adjusted, but not full-dose, sorafenib is a cost-effective treatment compared to BSC in intermediate and advanced HCC. (HEPATOLOGY 2013)

引用

页码：1046 / 1054

页数：9