title: Cost-effectiveness analysis of axitinib through a probabilistic decision model.
abstract: BACKGROUND
  The Oncology field is characterised by a steady increase in demand and a consistent launching of innovative and expensive products. Therefore, cost-effectiveness analysis can contribute as a significant decision-making tool by elucidating the most economically efficient ways to satisfy compelling health needs.
  
  
  METHODS
  The scope of this study is to estimate the cost-effectiveness of axitinib versus sorafenib, for the second-line treatment of renal cell carcinoma. A literature review for evidence synthesis was performed and a probabilistic Markov Model was employed to simulate disease progression. This study will also assess Value of Information.
  
  
  CONCLUSIONS
  Compared to sorafenib, axitinib resulted in an incremental cost of 87,936 euro per quality adjusted life year. The probability of axitinib to being cost-effective at the willingness-to-pay threshold of 60,000 euro was 13%, while the corresponding probability of being cost-effective at the highest recommended willingness-to-pay threshold of 100,000 euro was 69.9%. Uncertainty was primarily attributed to the price of the product, the utility values, the progression-free survival and to a lesser degree to the overall survival. Axitinib can be considered as a cost-effective therapeutic option for second-line treatment of renal cell carcinoma.
authors.affiliation: Open University of Cyprus, Health Care Management Programme , Cyprus , Europe.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Petrou
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D000077784:Axitinib; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D007093:Imidazoles / Q000191:economics* / Q000627:therapeutic use; D007191:Indazoles / Q000191:economics* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000191:economics*; D008390:Markov Chains; D018803:Models, Economic; D009536:Niacinamide / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000191:economics / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D000077157:Sorafenib; D035501:Uncertainty
chemical_list: D000970:Antineoplastic Agents; D007093:Imidazoles; D007191:Indazoles; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib; D000077784:Axitinib
keywords: axitinib; cost-effectiveness analysis; decision modelling; markov model; second-line renal cell carcinoma; sorafenib; value of information