Sunitinib has been shown to offer clinical benefits during the treatment of advanced renal cell carcinoma. However, molecular targeting drugs are expensive and can have a significant impact on medical expenses. The purpose of this study was to assess the cost-effectiveness of sunitinib as a first-line therapy compared with interferon-alpha (IFN-α) in metastatic renal cell carcinoma patients. A Markov model was used to show the clinical courses of patients with metastatic renal cell carcinoma who received sunitinib or IFN-α. The transition probabilities and utilities employed in this Markov model were derived from two sources. This study focused on the perspective of public healthcare payer, as only direct medical costs were estimated from the treatment schedule for metastatic renal cell cancer. In the cost-effectiveness analysis, outcomes were valued in terms of life years (LYs) and quality-adjusted life years (QALYs). We calculated the incremental cost-effectiveness ratio (ICER) during the cost-effectiveness analysis. The results were tested using Monte Carlo simulations. Sunitinib and IFN-α treatment resulted in LYs of 2.40 years and 2.03 years, QALYs of 1.58 and 1.25, and expected costs of 13,572,629 yen and 6,083,002 yen, respectively. As a result, the ICER associated with replacing IFN-α with sunitinib was 22,695,839 yen/QALYs. Our results suggest that compared with IFN-α, sunitinib prolongs LYs and QALYs, but the increases in quality achieved by sunitinib are more expensive than those produced by IFN-α.
Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan. 2018 Jan [Epub]
Kazuki Tomura, Yuki Naito, Tomiko Sunaga, Tatsuya Kurihara, Masahiro Usuda, Akiko Nagatani, Yumiko Ogawa, Nao Akiyama, Haruaki Sasaki, Tatsunori Murata, Hiroyuki Sakamaki, Mari Kogo, Tadanori Sasaki
Department of Pharmacy, Showa University Fujigaoka Hospital., Department of Hospital Pharmaceutics, School of Pharmacy, Showa University., Department of Urology, Showa University Fujigaoka Hospital., CRECON MEDICAL ASSESSMENT INC., Department of Management, Tokyo University of Science.