title: Cost-effectiveness of sorafenib compared to best supportive care in second line renal cell cancer from a payer perspective in Cyprus.
abstract: 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.
authors.affiliation: Health Care Management Programme, Open University of Cyprus, Nicosia, Cyprus.
authors.forename: Panagiotis Ke
authors.initials: PK
authors.lastname: Petrou
authors.forename: Michael A
authors.initials: MA
authors.lastname: Talias
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D003535:Cyprus; D003661:Decision Support Techniques; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000191:economics; D008390:Markov Chains; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000191:economics / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D019057:Quality-Adjusted Life Years; D012051:Reimbursement Mechanisms; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib