title: Cost-effectiveness of pazopanib in advanced soft tissue sarcoma in the United kingdom.
abstract: In the phase III PALETTE trial, pazopanib improved progression-free survival (PFS) compared with placebo in patients with advanced/metastatic soft tissue sarcomas (mSTS) who had received prior chemotherapy. We used a multistate model to estimate expected PFS, overall survival (OS), lifetime STS treatment costs, and quality-adjusted life-years (QALYs) for patients receiving pazopanib, placebo, trabectedin, ifosfamide, or gemcitabine plus docetaxel as second-line mSTS therapies. The cost-effectiveness of pazopanib was expressed as the incremental costs per QALY gained. Estimates of PFS/OS, adverse events, and utilities for pazopanib and placebo were from the PALETTE trial. Estimates of relative effectiveness of the other comparators were from an unadjusted indirect comparison versus pazopanib. Costs were from published sources. Pazopanib is estimated to increase QALYs by 0.128 and costs by £7,976 versus placebo; cost per QALY gained with pazopanib versus placebo is estimated to be £62,000. Compared with the other chemotherapies, pazopanib provides similar QALYs at a lower cost. Pazopanib may not be cost-effective versus placebo but may be cost-effective versus the most commonly used active treatments, although this conclusion is uncertain. Given the unmet need for effective treatments for mSTS, pazopanib may be an appropriate alternative to some currently used medications in the United Kingdom.
authors.affiliation: Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA 02445, USA.
authors.forename: Jordan
authors.identifier: 0000-0002-2570-5686
authors.initials: J
authors.lastname: Amdahl
authors.affiliation: GlaxoSmithKline, Stockley Park West, Uxbridge, Middlesex UB11 1BT, UK.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Manson
authors.affiliation: GlaxoSmithKline, Stockley Park West, Uxbridge, Middlesex UB11 1BT, UK.
authors.forename: Robert
authors.identifier: 0000-0003-4447-3881
authors.initials: R
authors.lastname: Isbell
authors.affiliation: GlaxoSmithKline, 7333 Mississauga Road, Mississauga, ON, Canada L5N 6L4 ; University of Toronto, 144 College Street, Toronto, ON, Canada M5S 3M2.
authors.forename: Ayman
authors.identifier: 0000-0002-3040-9312
authors.initials: A
authors.lastname: Chit
authors.affiliation: GlaxoSmithKline, Stockley Park West, Uxbridge, Middlesex UB11 1BT, UK.
authors.forename: Jose
authors.initials: J
authors.lastname: Diaz
authors.affiliation: York Health Economics Consortium, Level 2, Market Square, University of York, Heslington, York YO10 5NH, UK.
authors.forename: Lily
authors.identifier: 0000-0002-8204-8109
authors.initials: L
authors.lastname: Lewis
authors.affiliation: Policy Analysis Inc. (PAI), Four Davis Court, Brookline, MA 02445, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Delea