TY - JOUR
T1 - Economic impact of sunitinib and sorafenib use in metastatic renal cell carcinoma treatment in Veneto Region, Italy
AU - Ballali, Simonetta
AU - Chiffi, Daniele
AU - Trojniak, Marta P.
AU - Gregori, Dario
AU - Gregori, Dario
AU - Chiffi, Daniele
AU - Grigoletto, Francesco
AU - Perissinotto, Egle
AU - Buja, Alessandra
AU - Tramarina, Andrea
AU - Gallo, Costantino
AU - Compostella, Antonio
AU - Pastorelli, Davide
AU - Rausa, Giuseppe
PY - 2013
Y1 - 2013
N2 - Objective: To evaluate the impact of multitargeted tyrosine kinase inhibitors (TKI) considering 1st and 2nd line treatment for a full period of 3 years in the eligible patients of Veneto Region. Methods: A Markov state decision model was selected to evaluate the cost impact of sunitinib and sorafenib use for a lapse of time of three years in Veneto public hospitals, considering transition probabilities from three different states and by comparing the expected deaths and the monthly survival rates in treatment and no-treatment groups. Results: From the initial cohort of 357 patients eligible for sunitinib treatment, stable ones (139) were considered in order to evaluate the impact of the multitargeted agent on overall progression of the disease. Results showed that a smaller portion of patients receiving sunitinib transited from a stable to a progressive state, with respect to the patients who were not receiving sunitinib. The cost of 6 months treatment with sunitinib reached a median value of 2532666€, increasing till 3607807€, as cumulative amount at 12 months. Costs after the 1st year flattened around the same figure (3800000€) due to the transition towards death or 2nd line treatments. Discussion: the costs of the first 6 months therapy with sunitinib have a very high impact on public health expenses in the Regione Veneto. 2nd line treatment with sorafenib instead increased overall expenses of a reduced proportion, due to the small proportion of patients undergoing this treatment and the relative inferior cost of the drug. Conclusion: From what came out from our simulated model on costs borne by the SSN for the treatment of patients with mRCC, we can conclude that they are effective on the progression of the disease the greatest impact being the cost for the 1st line pharmacological treatment.
AB - Objective: To evaluate the impact of multitargeted tyrosine kinase inhibitors (TKI) considering 1st and 2nd line treatment for a full period of 3 years in the eligible patients of Veneto Region. Methods: A Markov state decision model was selected to evaluate the cost impact of sunitinib and sorafenib use for a lapse of time of three years in Veneto public hospitals, considering transition probabilities from three different states and by comparing the expected deaths and the monthly survival rates in treatment and no-treatment groups. Results: From the initial cohort of 357 patients eligible for sunitinib treatment, stable ones (139) were considered in order to evaluate the impact of the multitargeted agent on overall progression of the disease. Results showed that a smaller portion of patients receiving sunitinib transited from a stable to a progressive state, with respect to the patients who were not receiving sunitinib. The cost of 6 months treatment with sunitinib reached a median value of 2532666€, increasing till 3607807€, as cumulative amount at 12 months. Costs after the 1st year flattened around the same figure (3800000€) due to the transition towards death or 2nd line treatments. Discussion: the costs of the first 6 months therapy with sunitinib have a very high impact on public health expenses in the Regione Veneto. 2nd line treatment with sorafenib instead increased overall expenses of a reduced proportion, due to the small proportion of patients undergoing this treatment and the relative inferior cost of the drug. Conclusion: From what came out from our simulated model on costs borne by the SSN for the treatment of patients with mRCC, we can conclude that they are effective on the progression of the disease the greatest impact being the cost for the 1st line pharmacological treatment.
KW - Cost
KW - Metastasis
KW - Renal cell cancer
KW - Sorafenib
KW - Sunitinib
KW - Veneto
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U2 - 10.2174/1874143601307010002
DO - 10.2174/1874143601307010002
M3 - Article
AN - SCOPUS:84879190716
VL - 7
SP - 2
EP - 8
JO - Open Pharmacology Journal
JF - Open Pharmacology Journal
SN - 1874-1436
IS - SPEC ISS 1
ER -