PMID- 24991363
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140703
LR  - 20211021
IS  - 1942-2962 (Print)
IS  - 1942-2970 (Electronic)
IS  - 1942-2962 (Linking)
VI  - 6
IP  - 5
DP  - 2013 Jul
TI  - Review of US Comparative Economic Evidence for Treatment of Metastatic Renal Cell 
      Carcinoma after Failure of First-Line VEGF Inhibitor Therapy.
PG  - 275-86
AB  - BACKGROUND: In 2006, the economic burden of metastatic renal cell carcinoma 
      (mRCC) was estimated to be up to $1.6 billion worldwide and has since grown 
      annually. With the continuing increase of the economic burden of this disease in 
      the United States, there is a growing need for economic analyses to guide 
      treatment and policy decisions for this patient population. OBJECTIVE: To 
      evaluate available comparative economic data on targeted therapies for patients 
      with mRCC who have failed first-line targeted therapies. METHOD: A broad and 
      comprehensive literature review was conducted of US-based studies between January 
      1, 2005, and February 11, 2013, evaluating comparative economic evidence for 
      targeted agents that are used as second-line therapy or beyond. Based on the 
      specific search parameters that focused on cost-effectiveness and economic 
      comparisons between vascular endothelial growth factor (VEGF)/VEGF receptor 
      (VEGFr) inhibitors and mammalian target of rapamycin (mTOR) inhibitors, only 7 
      relevant, US-based economic evaluations were found appropriate for inclusion in 
      the analysis. All authors, who are experts in the health economics and outcomes 
      research field, reviewed the search results. Studies of interest were those with 
      a targeted agent, VEGF/VEGFr or mTOR inhibitor, in at least 1 study arm. 
      DISCUSSION: As a group, targeted therapies were found to be cost-effective 
      options in treating patients with refractory mRCC in the United States. Oral 
      therapies showed an economic advantage over intravenous agents, presumably 
      because oral therapies have a lower impact on outpatient resources. Based on 3 
      studies, everolimus has been shown to have an economic advantage over 
      temsirolimus and to be cost-effective compared with sorafenib. No economic 
      comparison between everolimus and axitinib, the only 2 drugs with a National 
      Comprehensive Cancer Network category 1 recommendation for use after the failure 
      of VEGFr tyrosine kinase inhibitors, is available. CONCLUSION: The limited and 
      heterogeneous sum of the currently available economic evidence does not allow 
      firm conclusions to be drawn about the most cost-effective targeted treatment 
      option in the second-line setting and beyond in patients with mRCC. It is hoped 
      that ongoing head-to-head therapeutic trials and biomarker studies will help 
      improve the economic efficiency of these expensive agents.
FAU - Wong, Michael K
AU  - Wong MK
AD  - Dr Wong is Professor of Medicine, Keck School of Medicine, University of Southern 
      California, Los Angeles, CA.
FAU - Wang, Xufang
AU  - Wang X
AD  - Dr Wang is Director, Worldwide Health Outcomes, Value & Access, Novartis 
      Pharmaceuticals.
FAU - Chulikavit, Maruit J
AU  - Chulikavit MJ
AD  - Mr Chulikavit is Associate Director, LA-SER Analytica International, New York, 
      NY.
FAU - Liu, Zhimei
AU  - Liu Z
AD  - Dr Liu is Director, Oncology US Health Economics & Outcomes Research, Novartis 
      Pharmaceuticals, East Hanover, NJ.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Health Drug Benefits
JT  - American health & drug benefits
JID - 101479877
PMC - PMC4031714
EDAT- 2014/07/06 06:00
MHDA- 2014/07/06 06:01
PMCR- 2013/07/01
CRDT- 2014/07/04 06:00
PHST- 2014/07/04 06:00 [entrez]
PHST- 2014/07/06 06:00 [pubmed]
PHST- 2014/07/06 06:01 [medline]
PHST- 2013/07/01 00:00 [pmc-release]
PST - ppublish
SO  - Am Health Drug Benefits. 2013 Jul;6(5):275-86.