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

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

Risultato della ricerca: Contributo in rivistaArticolo in rivista

76 Citazioni (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.
Lingua originaleEnglish
pagine (da-a)1046-1054
Numero di pagine9
RivistaHepatology
Volume57
DOI
Stato di pubblicazionePubblicato - 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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