Cost and Effectiveness of the use of Sorafenib in Differentiated Thyroid Cancer

OBJECTIVES: The prevalence of differentiated thyroid cancer (DTC) locally advanced or metastatic refractory to radioactive iodine (RAI) has been increasing in the past decade. The treatments related to this condition are limited and are associated with substantial direct medical costs, low quality o...

Full description

Saved in:
Bibliographic Details
Published in:Value in health 2017-10, Vol.20 (9), p.A876
Main Authors: Carrasquilla-Sotomayor, M, Alvis-Zakzuk, NJ, Gomez de la Rosa, F, Alvis Zakzuk, J, Marrugo Figueroa, RD, Miranda Machado, P, Alvis Guzman, N, Herran Diazgranado, SE
Format: Article
Language:English
Subjects:
Cancer therapies
Cost analysis
Cost control
Costing
Health care expenditures
Inpatient care
Iodine
Medical treatment
Metastases
Monte Carlo simulation
Patients
Quality of life
Savings
Sensitivity analysis
Simulation
Survival
Systematic review
Targeted cancer therapy
Thyroid cancer
Uncertainty
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:OBJECTIVES: The prevalence of differentiated thyroid cancer (DTC) locally advanced or metastatic refractory to radioactive iodine (RAI) has been increasing in the past decade. The treatments related to this condition are limited and are associated with substantial direct medical costs, low quality of life and survival. The aim of this study was to estimate the cost and effectiveness of sorafenib administrated in radioiodine-refractory DTC patients in Colombia. METHODS: We adapted a Markov Model to simulate the process of radioiodine-refractory DTC patients treated with sorafenib. Clinical data were obtained from a systematic review. Costs were estimated from a standard costing based on expert panel. The primary outcomes were costs and QALYS. We performed one-way sensitivity analysis as well as probabilistic sensitivity analysis based on Monte Carlo simulation of 1000 iterations to explore the uncertainty of the parameters used in the model. RESULTS: The estimated direct medical cost of DTC-RAI was COP $ 575,512 in ambulatory patients. The standard cost of the disease progression was COP $ 2,481,336 in outpatient and COP $ 10,812,295 in inpatient.The progression free survival was 1.30 months for sorafenib and 0.45 for Best Supportive Care (BSC).The monthly costs of treatments were COP $ 20,510,821 and COP $ 9,138,752 for BSC and Sorafenib, respectively. Treatment with sorafenib resulted in additional gains in terms of effectiveness compared to the BSC option. (0.67 QALYs more than treatment with BSC which reported gains of 1.74 QALYs). Moreover, sorafenib results in cost savings for early progression in COP $ 11,299,586 compared to BSC. CONCLUSIONS: Sorafenib is a treatment that delays disease progression. Also, given its cost savings results, is a potentially cost effective treatment option in patients with DTC-RAI in Colombia.
ISSN:1098-3015
1524-4733
DOI:10.1016/j.jval.2017.08.2585