1034P - Economic evaluation of pazopanib as first-line treatment of metastatic renal cell carcinoma in Greece

Date 09 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Bioethics, Legal, and Economic Issues
Presenter Argyro Solakidi
Citation Annals of Oncology (2016) 27 (6): 351-358. 10.1093/annonc/mdw377
Authors A. Solakidi1, G. Kourlaba1, L. Kontovinis2, E. Bournakis3, A. Boutis4, K. Koutsoukos5, I. Syrios6, A. Tzovaras7, M. Chatzikou8, C. Michailidi9, N. Maniadakis10
  • 1Health Economics, EVROSTON LP, 11528 - Athens/GR
  • 2Medical Oncology, Oncomedicare, Thessaloniki/GR
  • 3Medical Oncology, Areteion Hospital, University of Athens, Athens/GR
  • 41st Department Of Clinical Oncology/chemotherapy, Theagenion Cancer Hospital, 540 07 - Thessaloniki/GR
  • 5Oncology Unit/ Department Of Clinical Therapeutics, Alexandra Hospital, 115 28 - Athens/GR
  • 6Medical Oncology, Hygeia Hospital, Athens/GR
  • 7Medical Oncology, Hippokration General Hospital, Athens/GR
  • 8Health Economics, Novartis Hellas, Athens/GR
  • 9Medical, Novartis Hellas, Athens/GR
  • 10Health Services Organization And Management, National School of Public Health, Athens/GR

Abstract

Background

The NCCN Kidney Cancer Panel lists pazopanib and sunitinib as category 1 options for first-line treatment for stage IV renal cell carcinoma (RCC) patient. The aim of this study was to evaluate the cost-effectiveness of pazopanib vs sunitinib as first-line treatment of metastatic RCC (mRCC) from a Greek third-party payer's perspective.

Methods

A 3-state partitioned survival model was used. Estimates of progression free survival (PFS) and overall survival (OS) were from the COMPARZ trial. Utility values were based on adverse events in COMPARZ and EQ-5D data from the VEG105192 trial. Cost inputs included drug acquisition and other treatment related costs including physician visits and lab and radiology tests. Resource use data were collected by DELPHI method from an expert panel of clinicians from private and public hospitals in Greece. A 5-year time horizon was used consistent with the maximum duration of follow-up in the final analysis of OS in COMPARZ. The incremental cost-effectiveness ratio (ICER) was calculated. A threshold of €35,000 per QALY gained was used, per WHO Guidelines. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted.

Results

In the base case, pazopanib was less costly and more effective (“dominant”) compared with sunitinib, with €3,676 lower lifetime costs per patient and 0.058 greater discounted QALYs (€25,464 vs €29,140 and 1.617 vs 1.558). DSA and PSA suggest these results are robust. In DSA, pazopanib was dominant for different assumptions regarding PFS and utilities (Table). In 66% of PSA simulations, pazopanib was projected to yield more QALYs and lower costs vs sunitinb. The probability that pazopanib is cost-effective vs sunitinib was estimated to be 90% given the ICER threshold.

Scenario Incremental Costs Incremental QALYs ICER
Base case (IRC PFS) -€3,676 0.058 Dominant
Investigator-assessed PFS -€2,804 0.059 Dominant

Conclusions

Pazopanib is likely to be dominant compared with sunitinib as first-line treatment of mRCC in the Greek healthcare setting.

Clinical trial identification

Legal entity responsible for the study

Dr. Georgia Kourlaba

Funding

Novartis Hellas

Disclosure

A. Solakidi, G. Kourlaba: EVROSTON LP received funding from Novartis Hellas for this study M. Chatzikou: Novartis employee. However, the study sponsor had no influence on the study design, data collection or writing of the abstract. C. Michailidi: Novartis employee. However, the study sponsor had no influence on the study design, data collection or writing of the abstract. All other authors have declared no conflicts of interest.