PMID- 25422989
OWN - NLM
STAT- MEDLINE
DCOM- 20151209
LR  - 20220316
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 18
IP  - 3
DP  - 2015 Mar
TI  - Lifetime cost of everolimus vs axitinib in patients with advanced renal cell 
      carcinoma who failed prior sunitinib therapy in the US.
PG  - 200-9
LID - 10.3111/13696998.2014.985789 [doi]
AB  - OBJECTIVE: Everolimus and axitinib are approved in the US to treat patients with 
      advanced renal cell carcinoma (RCC) after failure on sunitinib or sorafenib, and 
      one prior systemic therapy (e.g., sunitinib), respectively. Two indirect 
      comparisons performed to evaluate progression-free survival in patients treated 
      with everolimus vs axitinib suggested similar efficacy between the two 
      treatments. Therefore, this analysis compares the lifetime costs of these two 
      therapies among sunitinib-refractory advanced RCC patients from a US payer 
      perspective. RESEARCH DESIGN AND METHODS: A Markov model was developed to 
      simulate a cohort of sunitinib-refractory advanced RCC patients and estimate the 
      cost of treating patients with everolimus vs axitinib. The following health 
      states were included: stable disease without adverse events (AEs), stable disease 
      with AEs, disease progression (PD), and death. The model included the following 
      resources: active treatments, post-progression treatments, adverse events, 
      physician and nurse visits, scans and tests, and palliative care. Resource 
      utilization inputs were derived from a US claims database analysis. Additionally, 
      a 3% annual discount rate was applied to costs, and the robustness of the model 
      results was tested by conducting sensitivity analyses, including those on dosing 
      scheme and post-progression treatment costs. RESULTS: Base case results 
      demonstrated that patients treated with everolimus cost an average of $12,985 
      (11%) less over their lifetimes than patients treated with axitinib. The primary 
      difference in costs was related to active treatment, which was largely driven by 
      axitinib's higher dose intensity. RESULTS remained consistent across sensitivity 
      analyses for AE and PD treatment costs, as well as dose intensity and discount 
      rates. CONCLUSION: The results suggest that everolimus likely leads to lower 
      lifetime costs than axitinib for sunitinib-refractory advanced RCC patients in 
      the US.
FAU - Perrin, Allison
AU  - Perrin A
AD  - LASER Analytica , New York, NY , USA.
FAU - Sherman, Steven
AU  - Sherman S
FAU - Pal, Sumanta
AU  - Pal S
FAU - Chua, Andrew
AU  - Chua A
FAU - Gorritz, Magdaliz
AU  - Gorritz M
FAU - Liu, Zhimei
AU  - Liu Z
FAU - Wang, Xufang
AU  - Wang X
FAU - Culver, Kenneth
AU  - Culver K
FAU - Casciano, Roman
AU  - Casciano R
FAU - Garrison, Louis P
AU  - Garrison LP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141126
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Imidazoles)
RN  - 0 (Indazoles)
RN  - 0 (Indoles)
RN  - 0 (Pyrroles)
RN  - 9HW64Q8G6G (Everolimus)
RN  - C9LVQ0YUXG (Axitinib)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Antineoplastic Agents/economics/therapeutic use
MH  - Axitinib
MH  - Carcinoma, Renal Cell/*drug therapy/mortality
MH  - Cost-Benefit Analysis
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Dose-Response Relationship, Drug
MH  - Everolimus/adverse effects/*economics/*therapeutic use
MH  - Health Expenditures
MH  - Health Services/economics/statistics & numerical data
MH  - Humans
MH  - Imidazoles/adverse effects/*economics/*therapeutic use
MH  - Indazoles/adverse effects/*economics/*therapeutic use
MH  - Indoles/therapeutic use
MH  - Markov Chains
MH  - Models, Econometric
MH  - Pyrroles/therapeutic use
MH  - Quality-Adjusted Life Years
MH  - Sunitinib
MH  - United States
OTO - NOTNLM
OT  - Axitinib
OT  - Costs analysis
OT  - Economic models
OT  - Everolimus
OT  - Renal cell carcinoma
EDAT- 2014/11/26 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/11/26 06:00
PHST- 2014/11/26 06:00 [entrez]
PHST- 2014/11/26 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.3111/13696998.2014.985789 [doi]
PST - ppublish
SO  - J Med Econ. 2015 Mar;18(3):200-9. doi: 10.3111/13696998.2014.985789. Epub 2014 
      Nov 26.