Abstract
Background: Renal cell carcinoma (RCC) is the most common form of kidney cancer. Immunotherapy with interferon-a (IFNα) and interleukin-2 (IL-2) has been the historical therapy of choice for the treatment of locally advanced or metastatic RCC prior to the more recent development of targeted therapies, including sunitinib and bevacizumab (combined with IFNα). Clinically and statistically significant advantages have been shown with both sunitinib and the combination of bevacizumab + IFNα versus IFNα alone in the treatment of advanced or metastatic RCC. The present study evaluated the incremental costs of bevacizumab + IFNα versus sunitinib for the first-line treatment of advanced or metastatic RCC assuming similar efficacy for these treatments. Methods: The efficacy profiles of bevacizumab + IFNα or sunitinib alone have been shown (indirectly) to be similar in patients with RCC; indeed, median progression-free survival (PFS) with either treatment is in the 10- to 11-month range. Therefore, a cost-minimization analysis was performed, focusing on direct medical costs only (drugs, administration and management of adverse events). The analysis considered the perspective of the Italian National Health Service (NHS), comparing the cost of bevacizumab (10mg/kg) plus IFNα (9, 6 or 3 million IU [MIU]) versus sunitinib (50mg) as first-line therapies for advanced or metastatic clear-cell RCC. The average cost per treated patient (year 2010 values) was assessed for the two treatment options at 11 months (median PFS). Results: Assuming a PFS of 11 months for both treatment options, bevacizumab + IFNα (9 MIU) would be a lower cost strategy (cost savings of h2052 per patient) than sunitinib. This difference arises mainly from the reduction in the acquisition cost of bevacizumab to the NHS (risk-sharing agreement). The cost advantages for bevacizumab would increase in parallel with a reduction in IFNα dosing; for example, with IFNα 6 MIU the corresponding cost savings would be €4185, and with 3 MIU the cost advantage would be €6320 per patient. Conclusion: This analysis suggests that bevacizumab + IFNα is a cost-saving alternative to sunitinib in the treatment of first-line metastatic RCC. Its superior safety profile also meant that the cost of managing adverse events was lower for bevacizumab + IFNα than for sunitinib.
| Original language | English |
|---|---|
| Pages (from-to) | 507-517 |
| Number of pages | 11 |
| Journal | Clinical Drug Investigation |
| Volume | 31 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2011 |
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Keywords
- Bevacizumab
- Cost-analysis
- Cost-minimisation
- Interferon-alpha
- Monoclonal-antibodies
- Protein-tyrosine-kinase-inhibitors
- Renal-cell-carcinoma
- Sunitinib
- Vascular-endothelial-growth-factor-inhibitors.
ASJC Scopus subject areas
- Pharmacology (medical)
Cite this
Bevacizumab plus Interferon-α versus Sunitinib for First-Line Treatment of Renal Cell Carcinoma in Italy : A Cost-Minimization Analysis. / Ravasio, Roberto; Ortega, Cinzia; Sabbatini, Roberto; Porta, Camillo.
In: Clinical Drug Investigation, Vol. 31, No. 7, 2011, p. 507-517.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bevacizumab plus Interferon-α versus Sunitinib for First-Line Treatment of Renal Cell Carcinoma in Italy
T2 - A Cost-Minimization Analysis
AU - Ravasio, Roberto
AU - Ortega, Cinzia
AU - Sabbatini, Roberto
AU - Porta, Camillo
PY - 2011
Y1 - 2011
N2 - Background: Renal cell carcinoma (RCC) is the most common form of kidney cancer. Immunotherapy with interferon-a (IFNα) and interleukin-2 (IL-2) has been the historical therapy of choice for the treatment of locally advanced or metastatic RCC prior to the more recent development of targeted therapies, including sunitinib and bevacizumab (combined with IFNα). Clinically and statistically significant advantages have been shown with both sunitinib and the combination of bevacizumab + IFNα versus IFNα alone in the treatment of advanced or metastatic RCC. The present study evaluated the incremental costs of bevacizumab + IFNα versus sunitinib for the first-line treatment of advanced or metastatic RCC assuming similar efficacy for these treatments. Methods: The efficacy profiles of bevacizumab + IFNα or sunitinib alone have been shown (indirectly) to be similar in patients with RCC; indeed, median progression-free survival (PFS) with either treatment is in the 10- to 11-month range. Therefore, a cost-minimization analysis was performed, focusing on direct medical costs only (drugs, administration and management of adverse events). The analysis considered the perspective of the Italian National Health Service (NHS), comparing the cost of bevacizumab (10mg/kg) plus IFNα (9, 6 or 3 million IU [MIU]) versus sunitinib (50mg) as first-line therapies for advanced or metastatic clear-cell RCC. The average cost per treated patient (year 2010 values) was assessed for the two treatment options at 11 months (median PFS). Results: Assuming a PFS of 11 months for both treatment options, bevacizumab + IFNα (9 MIU) would be a lower cost strategy (cost savings of h2052 per patient) than sunitinib. This difference arises mainly from the reduction in the acquisition cost of bevacizumab to the NHS (risk-sharing agreement). The cost advantages for bevacizumab would increase in parallel with a reduction in IFNα dosing; for example, with IFNα 6 MIU the corresponding cost savings would be €4185, and with 3 MIU the cost advantage would be €6320 per patient. Conclusion: This analysis suggests that bevacizumab + IFNα is a cost-saving alternative to sunitinib in the treatment of first-line metastatic RCC. Its superior safety profile also meant that the cost of managing adverse events was lower for bevacizumab + IFNα than for sunitinib.
AB - Background: Renal cell carcinoma (RCC) is the most common form of kidney cancer. Immunotherapy with interferon-a (IFNα) and interleukin-2 (IL-2) has been the historical therapy of choice for the treatment of locally advanced or metastatic RCC prior to the more recent development of targeted therapies, including sunitinib and bevacizumab (combined with IFNα). Clinically and statistically significant advantages have been shown with both sunitinib and the combination of bevacizumab + IFNα versus IFNα alone in the treatment of advanced or metastatic RCC. The present study evaluated the incremental costs of bevacizumab + IFNα versus sunitinib for the first-line treatment of advanced or metastatic RCC assuming similar efficacy for these treatments. Methods: The efficacy profiles of bevacizumab + IFNα or sunitinib alone have been shown (indirectly) to be similar in patients with RCC; indeed, median progression-free survival (PFS) with either treatment is in the 10- to 11-month range. Therefore, a cost-minimization analysis was performed, focusing on direct medical costs only (drugs, administration and management of adverse events). The analysis considered the perspective of the Italian National Health Service (NHS), comparing the cost of bevacizumab (10mg/kg) plus IFNα (9, 6 or 3 million IU [MIU]) versus sunitinib (50mg) as first-line therapies for advanced or metastatic clear-cell RCC. The average cost per treated patient (year 2010 values) was assessed for the two treatment options at 11 months (median PFS). Results: Assuming a PFS of 11 months for both treatment options, bevacizumab + IFNα (9 MIU) would be a lower cost strategy (cost savings of h2052 per patient) than sunitinib. This difference arises mainly from the reduction in the acquisition cost of bevacizumab to the NHS (risk-sharing agreement). The cost advantages for bevacizumab would increase in parallel with a reduction in IFNα dosing; for example, with IFNα 6 MIU the corresponding cost savings would be €4185, and with 3 MIU the cost advantage would be €6320 per patient. Conclusion: This analysis suggests that bevacizumab + IFNα is a cost-saving alternative to sunitinib in the treatment of first-line metastatic RCC. Its superior safety profile also meant that the cost of managing adverse events was lower for bevacizumab + IFNα than for sunitinib.
KW - Bevacizumab
KW - Cost-analysis
KW - Cost-minimisation
KW - Interferon-alpha
KW - Monoclonal-antibodies
KW - Protein-tyrosine-kinase-inhibitors
KW - Renal-cell-carcinoma
KW - Sunitinib
KW - Vascular-endothelial-growth-factor-inhibitors.
UR - http://www.scopus.com/inward/record.url?scp=79957811491&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79957811491&partnerID=8YFLogxK
U2 - 10.2165/11590230-000000000-00000
DO - 10.2165/11590230-000000000-00000
M3 - Article
C2 - 21627339
AN - SCOPUS:79957811491
VL - 31
SP - 507
EP - 517
JO - Clinical Drug Investigation
JF - Clinical Drug Investigation
SN - 1173-2563
IS - 7
ER -