Cost-effectiveness of sorafenib for second-line treatment of advanced renal cell carcinoma

Martin Hoyle, Colin Green, Jo Thompson-Coon, Zulian Liu, Karen Welch, Tiffany Moxham, Ken Stein

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives
To estimate the cost-effectiveness of sorafenib (Nexavar, Bayer, Leverkusen, Germany) versus best supportive care (BSC) for second-line treatment of advanced renal cell carcinoma from the perspective of the UK National Health Service.

Methods
A decision analytic model was developed to estimate the cost-effectiveness of sorafenib. The clinical effectiveness of sorafenib versus BSC was taken from a recent randomized phase III trial. Utility values were taken from a phase II trial of sunitinib, using EQ-5D tariffs. Cost data were obtained from published literature and were based on current UK practice. The effect of parameter uncertainty on cost-effectiveness was explored through extensive one-way and probabilistic sensitivity analyses.

Results
Compared to BSC, sorafenib treatment resulted in an incremental cost per quality-adjusted life year (QALY) gained of £75,398, based on an estimated mean gain of 0.27 QALYs per patient, at a mean additional cost of £20,063 (inflated to 2007/2008). The probability that sorafenib is cost-effective compared to BSC at a willingness to pay threshold of £30,000 per QALY is 0.0%. In sensitivity analysis, estimates of cost per QALY were sensitive to changes in the clinical effectiveness parameters, and to health state utilities and drug costs.

Conclusions
Sorafenib has been shown to be clinically effective compared to BSC, offering additional health benefits; however, with a cost per QALY in excess of £70,000, it may not be regarded as a cost-effective use of resources in some health-care settings.
Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalValue in Health
Volume13
Issue number1
DOIs
Publication statusPublished - 2010
Externally publishedYes

Keywords

  • cost-effectiveness
  • cost-utility
  • decision analytic modeling
  • Nexavar
  • renal cell carcinoma
  • sorafenib

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