Presentation (CTI)

OBJECTIVES: Renal cell carcinoma (RCC) is the seventh most common cancer in men and the ninth most common in women globally. It imposes a significant economic burden due to the high costs of diagnosis, treatment, and long-term management, especially in advanced stages. In Mexico, 5,925 new cases of kidney cancer and 3,083 deaths were reported in 2020, making it one of the 10 deadliest cancer types nationwide. A cost-effectiveness analysis was conducted to compare Axitinib (Caxetib®) and Everolimus as second-line treatments for advanced RCC, from the perspective of the National Oncology Institute of Mexico (INCAN).
METHODS: A Markov model was developed to estimate direct medical costs and health outcomes at the National Oncology Institute of Mexico (INCAN) for two available treatments: Axitinib (Caxetib®) and Everolimus. The analysis applied a 3.0% annual discount rate over a 3-year time horizon. Patients transitioned among three health states—progression-free, progressed, and deceased—based on overall survival (OS) and progression-free survival (PFS) data derived from Kaplan-Meier curves in the scientific literature. Active treatment was provided until disease progression, after which patients received best supportive care (BSC). Costs related to wholesale drug acquisition and adverse events (AEs) were sourced directly from INCAN. A probabilistic sensitivity analysis (PSA) was conducted to evaluate model uncertainty.
RESULTS: The total cost per patient was $6,175.28 for Axitinib and $10,038.19 for Everolimus. Over a 3-year period, Axitinib provided 0.7524 life years (LYs) compared to 0.6790 LYs for Everolimus. Axitinib dominated Everolimus by achieving an additional 0.0734 LYs while reducing costs. Probabilistic sensitivity analysis (10,000 Monte Carlo iterations) confirmed the robustness and consistency of these findings.
CONCLUSIONS: Axitinib is a dominant alternative as a second-line treatment of patients with advanced RCC, versus everolimus, on a typical willingness-to-pay threshold.