Cost-effectiveness of sorafenib treatment in field practice for patients with hepatocellular carcinoma

Calogero Cammà, Giuseppe Cabibbo, Salvatore Petta, Marco Enea, Massimo Iavarone, Antonio Grieco, Antonio Gasbarrini, Erica Villa, Claudio Zavaglia, Raffaele Bruno, Rosa Anna Bruno, Massimo Colombo, Antonio Craxì

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78 Citations (Scopus)

Abstract

The purpose was to assess the cost-effectiveness of sorafenib in the treatment of hepatocellular carcinoma (HCC) patients incorporating current prices and the results of the recent published field practice SOraFenib Italian Assessment (SOFIA) study. We created a Markov Decision Model to evaluate, in a hypothetical cohort of Caucasian male patients, aged 67 years with Barcelona Clinic Liver Cancer (BCLC) C HCC, or BCLC B HCC who were unfit or failed to respond to locoregional therapies, well compensated cirrhosis, and with performance status 0-1 according to Eastern Cooperative Oncology Group (ECOG), the cost-effectiveness of the following strategies: (1) full or dose-adjusted sorafenib for BCLC B and C patients together; (2) full or dose-adjusted sorafenib for BCLC B patients; (3) full or dose-adjusted sorafenib for BCLC C patients. Outcomes include quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratio (ICER). In the base-case analysis dose-adjusted sorafenib was the most effective of the evaluated strategies. For dose-adjusted sorafenib, QALY was 0.44 for BCLC B and C patients together, 0.44 for BCLC C patients, and 0.38 for BCLC B patients. The ICER of dose-adjusted sorafenib compared with BSC was €34,534 per QALY gained for BCLC B and C patients together, €27,916 per QALY gained for BCLC C patients, and €54,881 per QALY gained for BCLC B patients. Results were sensitive to BSC survival rate, and sorafenib treatment duration.
Original languageEnglish
Pages (from-to)1046-1054
Number of pages9
JournalHepatology
Volume57
DOIs
Publication statusPublished - 2013

Keywords

  • Aged
  • Antineoplastic Agents
  • Carcinoma, Hepatocellular
  • Cost-Benefit Analysis
  • Drug Costs
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms
  • Male
  • Markov Chains
  • Multivariate Analysis
  • Niacinamide
  • Phenylurea Compounds
  • Prospective Studies
  • Quality-Adjusted Life Years

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