Health Care Management Programme, Open University of Cyprus, Nicosia, Cyprus.
Expert Rev Pharmacoecon Outcomes Res. 2014 Feb;14(1):131-8. doi: 10.1586/14737167.2014.873703. Epub 2014 Jan 7.
The objective of this study is to assess the cost effectiveness of sorafenib as a second line treatment of advanced renal cell carcinoma compared to standard best supportive care (BSC) in Cyprus. A probabilistic Decision analytic Markov Model was created to simulate disease progression and data from landmark trials were used. Actual local costs were set according to current guidelines in Cyprus. The incremental cost per quality adjusted life year of sorafenib versus BSC was €102,059. The probability of sorafenib to be cost effective at the threshold of €60,000 was 0%. Total costs were sensitive to the price of product, its effectiveness and to a lesser degree to the utility values. Sorafenib demonstrated superior clinical effectiveness compared to BSC, but it's not cost effective under current willingness to pay threshold. Its orphan status along with solidarity principle may justify reimbursement on an individual patient basis.
本研究旨在评估索拉非尼作为二线治疗晚期肾细胞癌的成本效果，与塞浦路斯的标准最佳支持治疗（BSC）相比。建立了一个概率决策分析马尔可夫模型来模拟疾病进展，并使用了标志性试验的数据。根据塞浦路斯的现行指南设定了实际的当地成本。与 BSC 相比，索拉非尼每质量调整生命年的增量成本为 102059 欧元。索拉非尼在 60000 欧元的阈值下具有成本效益的概率为 0%。总成本对产品价格、疗效较为敏感，对效用值的敏感度较低。与 BSC 相比，索拉非尼具有更好的临床疗效，但在当前的支付意愿阈值下并不具有成本效益。其孤儿药地位和团结原则可能证明在个别患者的基础上进行报销是合理的。
