Please use this identifier to cite or link to this item:
https://open.uns.ac.rs/handle/123456789/8527
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Jovan Mihajlović | en_US |
dc.contributor.author | Petros Pechlivanoglou | en_US |
dc.contributor.author | Ana Sabo | en_US |
dc.contributor.author | Zdenko Tomić | en_US |
dc.contributor.author | Maarten Postma | en_US |
dc.date.accessioned | 2019-09-30T09:09:20Z | - |
dc.date.available | 2019-09-30T09:09:20Z | - |
dc.date.issued | 2013-12-01 | - |
dc.identifier.issn | 1492918 | en_US |
dc.identifier.uri | https://open.uns.ac.rs/handle/123456789/8527 | - |
dc.description.abstract | Background: New targeted therapeutics for metastatic renal cell carcinoma (mRCC) enable an increment in progression-free survival (PFS) ranging from 2 to 6 months. Compared with best supportive care, everolimus demonstrated an additional PFS of 3 months in patients with mRCC whose disease had progressed on sunitinib and/or sorafenib. The only targeted therapy for mRCC currently reimbursed in Serbia is sunitinib. Objective: The aim of this study was to estimate the cost-effectiveness and the budget impact of the introduction of everolimus in Serbia in comparison to best supportive care, for mRCC patients refractory to sunitinib. Methods: A Markov model was designed corresponding with Serbian treatment protocols. A health care payer perspective was taken, including direct costs only. Treated and untreated cohorts were followed up over 18 cycles, each cycle lasting 8 weeks, which covered the lifetime horizon of mRCC patients refractory to the first-line treatment. Annual discounted rates of 1.5% for effectiveness and 3% for costs were applied. Transitions between health states were modeled by time-dependent probabilities extracted from published Kaplan-Meier curves of PFS and overall survival (OS). Utility values were obtained from the appraisals of other mRCC treatments. One-way and probabilistic sensitivity analyses were done to test the robustness and uncertainty of the base-case estimate. Lastly, the potential impacts of everolimus on the overall health care expenditures on annual and 4-year bases were estimated in the budget-impact analysis. Results: The incremental cost-effectiveness ratio for everolimus was estimated at €86,978 per quality-adjusted life-year. Sensitivity analysis identified the hazard multiplier, a statistical approximator of OS gain, as the main driver of everolimus cost-effectiveness. Furthermore, probabilistic sensitivity analyses revealed a wide 95% CI around the base-case incremental cost-effectiveness ratio estimate (€32,594-€425,258 per quality-adjusted life-year). Finally, an average annual budgetary impact of everolimus in first 4 years after its potential reimbursement would be around €270,000, contributing to <1% of the total budget in Serbian oncology. Conclusions: Everolimus as a second-line treatment of mRCC is not likely to be a cost-effective option under the present conditions in Serbia, with a relatively limited impact on its budget in oncology. A major constraint on the estimation of the cost-effectiveness of everolimus relates to the uncertainty around the everolimus effect on extending OS. However, prior to a final decision on the acceptance/rejection of everolimus, reassessment of the whole therapeutic group might be needed to construct an economically rational treatment strategy within the mRCC field. © 2013 Elsevier HS Journals, Inc. | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Clinical Therapeutics | en_US |
dc.subject | cost-effectiveness | en_US |
dc.subject | everolimus | en_US |
dc.subject | renal cell carcinoma | en_US |
dc.subject | Serbia | en_US |
dc.title | Cost-Effectiveness of Everolimus for Second-Line Treatment of Metastatic Renal Cell Carcinoma in Serbia | en_US |
dc.type | Journal/Magazine Article | en_US |
dc.identifier.doi | 10.1016/j.clinthera.2013.10.004 | - |
dc.identifier.pmid | 35 | - |
dc.identifier.scopus | 2-s2.0-84890312245 | - |
dc.identifier.url | https://api.elsevier.com/content/abstract/scopus_id/84890312245 | - |
dc.description.version | Published | en_US |
dc.relation.lastpage | 1922 | en_US |
dc.relation.firstpage | 1909 | en_US |
dc.relation.issue | 12 | en_US |
dc.relation.volume | 35 | en_US |
item.fulltext | No Fulltext | - |
item.grantfulltext | none | - |
crisitem.author.dept | Medicinski fakultet, Katedra za farmakologiju i toksikologiju | - |
crisitem.author.parentorg | Medicinski fakultet | - |
Appears in Collections: | MDF Publikacije/Publications |
SCOPUSTM
Citations
10
checked on May 10, 2024
Page view(s)
20
Last Week
7
7
Last month
0
0
checked on May 10, 2024
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.