title: Cost-effectiveness of pazopanib in advanced soft-tissue sarcoma in Canada.
abstract: BACKGROUND
  In the phase iii palette trial of pazopanib compared with placebo in patients with advanced or metastatic soft-tissue sarcoma (sts) who had received prior chemotherapy, pazopanib treatment was associated with improved progression-free survival (pfs). We used an economic model and data from palette and other sources to evaluate the cost-effectiveness of pazopanib in patients with advanced sts who had already received chemotherapy.
  
  
  METHODS
  We developed a multistate model to estimate expected pfs, overall survival (os), lifetime sts treatment costs, and quality-adjusted life-years (qalys) for patients receiving pazopanib or placebo as second-line therapy for advanced sts. Cost-effectiveness was calculated alternatively from the health care system and societal perspectives for the province of Quebec. Estimated pfs, os, incidence of adverse events, and utilities values for pazopanib and placebo were derived from the palette trial. Costs were obtained from published sources.
  
  
  RESULTS
  Compared with placebo, pazopanib is estimated to increase qalys by 0.128. The incremental cost of pazopanib compared with placebo is CA$20,840 from the health care system perspective and CA$15,821 from the societal perspective. The cost per qaly gained with pazopanib in that comparison is CA$163,336 from the health care system perspective and CA$124,001 from the societal perspective.
  
  
  CONCLUSIONS
  Compared with placebo, pazopanib might be cost-effective from the Canadian health care system and societal perspectives depending on the threshold value used by reimbursement authorities to assess novel cancer therapies. Given the unmet need for effective treatments for advanced sts, pazopanib might nevertheless be an appropriate alternative to currently used treatments.
authors.affiliation: Policy Analysis Inc. ( pai ), Brookline, MA, U.S.A.
authors.forename: T E
authors.initials: TE
authors.lastname: Delea
authors.affiliation: Policy Analysis Inc. ( pai ), Brookline, MA, U.S.A.
authors.forename: J
authors.initials: J
authors.lastname: Amdahl
authors.affiliation: Health Outcomes-Oncology, Medical Division, GlaxoSmithKline, Mississauga, ON.
authors.forename: H R
authors.initials: HR
authors.lastname: Nakhaipour
authors.affiliation: Global Health Outcomes-Oncology, GlaxoSmith-Kline, Stockley Park, Uxbridge, Middlesex, U.K.
authors.forename: S C
authors.initials: SC
authors.lastname: Manson
authors.affiliation: Policy Analysis Inc. ( pai ), Brookline, MA, U.S.A.
authors.forename: A
authors.initials: A
authors.lastname: Wang
authors.affiliation: Policy Analysis Inc. ( pai ), Brookline, MA, U.S.A.
authors.forename: N
authors.initials: N
authors.lastname: Fedor
authors.affiliation: Health Outcomes-Oncology, Medical Division, GlaxoSmithKline, Mississauga, ON. ; University of Toronto, Toronto, ON.
authors.forename: A
authors.initials: A
authors.lastname: Chit
keywords: Cost-effectiveness; palliative care; partitioned-survival analysis; pazopanib; post-progression survival; quality-adjusted life-years; soft-tissue sarcoma