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Cost-Effectiveness Analysis of Pazopanib Versus Sunitinib for the Treatment of First-Line Advanced and/or Metastatic Renal Cell Carcinoma in China: Using Partitioned Survival Model and Markov Model

Speaker(s)

Jia H1, Miao P2
1Digital Health China Technologies Co., LTD, Beijing, 11, China, 2Digital Health China Technologies Co., LTD, Beijing, China

Presentation Documents

OBJECTIVES:

To evaluate the cost-effectiveness of pazopanib versus sunitinib for the treatment of first-line advance and/or metastatic renal cell carcinoma (a/m RCC) from the perspective of the Chinese healthcare system.

METHODS:

The partitioned survival (PS) model and Markov model with three health states (progression-free, progressed disease and death) were developed to estimate the long-term costs and health outcomes of treatment of a/m RCC with pazopanib or sunitinib. Transition probabilities were estimated using Kaplan-Meier distributions for PFS and OS from a pooled subgroup analysis of COMPARZ study. The costs of first-line and subsequent treatments, drug administration, adverse events management, BSC and terminal care were included in the model. Clinical data and utility values were derived from the previous published studies. The primary outcomes included the total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). In the base case, time horizon was 5 years, and costs and QALYs were discounted at a 3% annual discount ratio. Deterministic and probabilistic sensitivity analyses were performed to assess the impact on the results of methodological and parameter uncertainty.

RESULTS:

In the PS model, compared with sunitinib, pazopanib yield an additional 0.03 QALYs with a saving cost of $14,703, hence it was dominant in the base case analysis. In the Markov model, pazopanib yield a higher QALYs (+ 0.05) at lower costs (-$164), which drawn the consist conclusion that it dominated sunitinib. In the probabilistic sensitivity analysis on the PS and Markov model, the probability that pazopanib would be cost-effective was 78% and 54% at a willingness-to-pay threshold of 32,973 USD/QALY (3 GDP per capita), respectively. Results were robust to changes in key parameter values and assumptions.

CONCLUSIONS:

The findings of the present analysis suggest that pazopanib might be much more cost-effective than sunitinib in patients receiving fist-line treatment for advanced and/or metastatic renal cell carcinoma in China.

Code

EE133

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Drugs