RESEARCH ARTICLE


Economic Impact of Sunitinib and Sorafenib Use in Metastatic Renal Cell Carcinoma Treatment in Veneto Region, Italy



Simonetta Ballali1, Daniele Chiffi2, Marta P. Trojniak3, Dario Gregori*, 2, §
1 Prochild Onlus, Trieste, Italy & Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
2 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
3 Oncology Pharmacy Department, Istituto Oncologico Veneto, IRCCS, Padova, Italy

Article Information


Identifiers and Pagination:

Year: 2013
Volume: 7
First Page: 2
Last Page: 8
Publisher Id: TOPHARMJ-7-2
DOI: 10.2174/1874143601307010002

Article History:

Received Date: 9/10/2012
Revision Received Date: 9/1/2013
Acceptance Date: 14/1/2013
Electronic publication date: 19/4/2013
Collection year: 2012

© 2012 Ballali et al;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, Via Loredan 18, 35121 Padova, Italy; Tel: +390498275384; Fax: +3902700445089; E-mail: dario.gregori@unipd.it
§ EIHCD-VeRo (Economic Impact of High Cost Drugs in the Veneto Region) Research Project Agreement members: Dario Gregori (Principal Investigator), Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Daniele Chiffi, Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Francesco Grigoletto, Department of Environmental Medicine and Public Health, University of Padova, Italy; Egle Perissinotto, Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Alessandra Buja, Department of Molecular Medicine, University of Padova, Italy; Andrea Tramarina, Veneto Regional Health Agency, Italy; Costantino Gallo, Veneto Regional Health Agency, Italy; Antonio Compostella, Veneto Regional Health Agency, Italy; Davide Pastorelli, Istituto Oncologico del Veneto IRCSS, Padova, Italy; Giuseppe Rausa, Department of Environmental Medicine and Public Health, University of Padova, Italy.


Abstract

Objective:

To evaluate the impact of multitargeted tyrosine kinase inhibitors (TKI) considering 1st and 2nd line treatment for a full period of 3 years in the eligible patients of Veneto Region

Methods:

A Markov state decision model was selected to evaluate the cost impact of sunitinib and sorafenib use for a lapse of time of three years in Veneto public hospitals, considering transition probabilities from three different states and by comparing the expected deaths and the monthly survival rates in treatment and no-treatment groups.

Results:

From the initial cohort of 357 patients eligible for sunitinib treatment, stable ones (139) were considered in order to evaluate the impact of the multitargeted agent on overall progression of the disease. Results showed that a smaller portion of patients receiving sunitinib transited from a stable to a progressive state, with respect to the patients who were not receiving sunitinib. The cost of 6 months treatment with sunitinib reached a median value of 2532666, increasing till 3607807€ as cumulative amount at 12 months. Costs after the 1st year flattened around the same figure (3800000€) due to the transition towards death or 2nd line treatments.

Discussion:

the costs of the first 6 months therapy with sunitinib have a very high impact on public health expenses in the Regione Veneto. 2 line treatment with sorafenib instead increased overall expenses of a reduced proportion, due to the small proportion of patients undergoing this treatment and the relative inferior cost of the drug.

Conclusion:

From what came out from our simulated model on costs borne by the SSN for the treatment of patients with mRCC, we can conclude that they are effective on the progression of the disease the greatest impact being the cost for the 1st line pharmacological treatment.

Keywords: Cost, metastasis, renal cell cancer, sorafenib, sunitinib, Veneto.