Cost-utility of Sunitinib Versus Pazopanib in Metastatic Renal Cell Carcinoma in Canada using Real-world Evidence

被引:7
|
作者
Nazha, Sara [1 ]
Tanguay, Simon [1 ]
Kapoor, Anil [2 ]
Jewett, Michael [3 ]
Kollmannsberger, Christian [4 ]
Wood, Lori [5 ,6 ]
Bjarnason, G. A. Georg [7 ]
Heng, Daniel [8 ]
Soulieres, Denis [9 ]
Reaume, Martin Neil [10 ]
Basappa, Naveen [11 ]
Levesque, Eric [12 ]
Dragomir, Alice [13 ]
机构
[1] McGill Univ, Hlth Ctr, Montreal, PQ, Canada
[2] McMaster Univ, Hamilton, ON, Canada
[3] Princess Margaret Canc Ctr, Toronto, ON, Canada
[4] Univ British Columbia, Vancouver, BC, Canada
[5] Dalhousie Univ, Halifax, NS, Canada
[6] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada
[7] Univ Toronto, Sunnybrooke Hosp, Toronto, ON, Canada
[8] Univ Calgary, Tom Baker Canc Ctr, Calgary, AB, Canada
[9] Univ Montreal, Ctr Hosp Univ Montreal, Montreal, PQ, Canada
[10] Univ Ottawa, Ottawa, ON, Canada
[11] Univ Alberta, Cross Canc Inst, Edmonton, AB, Canada
[12] Univ Laval, Ctr Hosp Univ Quebec, Quebec City, PQ, Canada
[13] McGill Univ, Hlth Ctr, Res Inst, Hlth Econ & Outcomes Res,Surg Urol, 5252 Maisonneuve West, Montreal, PQ H4A 3S5, Canada
关键词
1ST-LINE TREATMENT; BREAST-CANCER; THERAPY; KIDNEY; OUTCOMES; MODEL; TRIAL;
D O I
10.1007/s40261-018-0705-6
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background and Objective The development of new targeted therapies in kidney cancer has shaped disease management in the metastatic phase. Our study aims to conduct a cost-utility analysis of sunitinib versus pazopanib in first-line setting in Canada for metastatic renal cell carcinoma (mRCC) patients using real-world data. Methods A Markov model with Monte-Carlo microsimulations was developed to estimate the clinical and economic outcomes of patients treated in first-line with sunitinib versus pazopanib. Transition probabilities were estimated using observational data from a Canadian database where real-life clinical practice was captured. The costs of therapies, disease progression, and management of adverse events were included in the model in Canadian dollars ($Can). Utility and disutility values were included for each health state. Incremental cost-utility ratio (ICUR) and incremental cost-effectiveness ratios (ICER) were calculated for a time horizon of 5years, from the Canadian Healthcare System perspective. Results The cost difference was $36,303 and the difference in quality-adjusted life year (QALY) was 0.54 in favour of sunitinib with an ICUR of $67,227/QALY for sunitinib versus pazopanib. The major cost component (56%) is related to best supportive care (BSC) where patients tend to stay for a longer period of time compared to other states. The difference in life years gained (LYG) between sunitinib and pazopanib was 1.21 LYG (33.51 vs 19.03months) and the ICER was $30,002/LYG. Sensitivity analysis demonstrated the robustness of the model with a high probability of sunitinib being a cost-effective option when compared to pazopanib. Conclusion When using real-world evidence, sunitinib is found to be a cost-effective treatment compared to pazopanib in mRCC patients in Canada.
引用
收藏
页码:1155 / 1165
页数:11
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