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. Conclusion: In daily practice dose-adjusted, but not full-dose, sorafenib is a cost-effective treatment compared to BSC in intermediate and advanced HCC.
Cost-effectiveness of sorafenib treatment in field practice for patients with hepatocellular carcinoma / C. Cammà, G. Cabibbo, S. Petta, M. Enea, M. Iavarone, A. Grieco, A. Gasbarrini, E. Villa, C. Zavaglia, R. Bruno, M. Colombo, A. Craxì. - In: HEPATOLOGY. - ISSN 0270-9139. - 57:3(2013), pp. 1046-1054.
|Titolo:||Cost-effectiveness of sorafenib treatment in field practice for patients with hepatocellular carcinoma|
COLOMBO, MASSIMO GIUSEPPE (Penultimo)
|Parole Chiave:||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; Hepatology|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||2013|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1002/hep.26221|
|Appare nelle tipologie:||01 - Articolo su periodico|