Abstract
Objectives
To estimate the cost-effectiveness of temsirolimus compared to interferon-α for first line treatment of patients with advanced, poor prognosis 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 temsirolimus. The clinical effectiveness of temsirolimus compared with interferon-α and the utility values (using EQ-5D tariffs) were taken from a recent phase III randomized clinical trial. Cost data were obtained from published literature and 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 interferon-α, temsirolimus treatment resulted in an incremental cost per QALY gained of £94,632; based on an estimated mean gain of 0.24 quality-adjusted life years (QALYs) per patient, at a mean additional cost of £22,331 (inflated to 2007/8). The cost per QALY for patient subgroups ranged from £74,369 to £154,752. The probability that temsirolimus is cost-effective compared to interferon-α at a willingness to pay threshold of £30,000 per QALY for all patient groups is expected to be close to zero. The cost per QALY was sensitive to the clinical effectiveness parameters, health state utilities, drug costs and the cost of administration of temsirolimus.
Conclusions
Temsirolimus has been shown to be clinically effective compared to interferon-α offering additional health benefits, however, with a cost per QALY in excess of £90,000, it may not be regarded as a cost-effective use of resources in some health care settings.
To estimate the cost-effectiveness of temsirolimus compared to interferon-α for first line treatment of patients with advanced, poor prognosis 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 temsirolimus. The clinical effectiveness of temsirolimus compared with interferon-α and the utility values (using EQ-5D tariffs) were taken from a recent phase III randomized clinical trial. Cost data were obtained from published literature and 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 interferon-α, temsirolimus treatment resulted in an incremental cost per QALY gained of £94,632; based on an estimated mean gain of 0.24 quality-adjusted life years (QALYs) per patient, at a mean additional cost of £22,331 (inflated to 2007/8). The cost per QALY for patient subgroups ranged from £74,369 to £154,752. The probability that temsirolimus is cost-effective compared to interferon-α at a willingness to pay threshold of £30,000 per QALY for all patient groups is expected to be close to zero. The cost per QALY was sensitive to the clinical effectiveness parameters, health state utilities, drug costs and the cost of administration of temsirolimus.
Conclusions
Temsirolimus has been shown to be clinically effective compared to interferon-α offering additional health benefits, however, with a cost per QALY in excess of £90,000, it may not be regarded as a cost-effective use of resources in some health care settings.
| Original language | English |
|---|---|
| Pages (from-to) | 61-68 |
| Number of pages | 8 |
| Journal | Value in Health |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2010 |
| Externally published | Yes |
Keywords
- cost-effectiveness
- cost-utility
- decision analytic modeling
- renal cell carcinoma
- temsirolimus
- Torisel