PMID- 25562771 OWN - NLM STAT- MEDLINE DCOM- 20150914 LR - 20240110 IS - 2376-1032 (Electronic) IS - 2376-0540 (Print) IS - 2376-0540 (Linking) VI - 21 IP - 1 DP - 2015 Jan TI - Health care costs among renal cancer patients using pazopanib and sunitinib. PG - 37-44, 44a-d LID - 10.18553/jmcp.2015.21.1.37 AB - BACKGROUND: Pazopanib was noninferior to sunitinib in progression-free survival in a phase III, open-label, randomized clinical trial comparing the efficacy and safety of the 2 drugs for treatment of patients with advanced renal cell carcinoma (RCC). A secondary analysis of this trial conducted on patient-reported health care resource utilization (HCRU) endpoints revealed significantly fewer monthly telephone consultations and emergency department visits among patients treated with pazopanib over the first 6 months of treatment. OBJECTIVES: To (a) compare total costs of HCRU and adverse events (AEs) in patients with advanced RCC receiving first-line pazopanib or sunitinib from the phase III clinical trial and (b) perform a post hoc economic analysis that applied direct medical care and pharmacy unit costs, obtained from the Truven Health MarketScan Databases, to HCRU and AE rates. METHODS: Total HCRU costs included components for provider contacts, diagnostics, hospitalizations, procedures, and study/nonstudy drugs. Patients were stratified by the presence or absence of an AE in order to estimate costs attributable to AEs. Costs were adjusted to 2013 U.S. dollars. The highest 1% of cost outliers were equally excluded from each group. Univariate (t-test and Kaplan-Meier sample average [KMSA]) and multivariate (using treatment group and region as covariates) analyses were performed. RESULTS: A total of 906 patients (pazopanib, n = 454; sunitinib, n = 452) reported HCRU; higher rates were observed for sunitinib. In unadjusted cost analyses, the mean total costs for pazopanib-treated patients were 8.0% lower than those treated with sunitinib ($80,464 vs. $86,886; P = 0.20). The difference in KMSA-estimated costs was significantly higher for sunitinib versus pazopanib ($156,128 vs. $143,585; P = 0.003). Adjusted cost differences between arms consistently suggested higher costs for sunitinib. Among patients who experienced greater than or equal to 1 AE, costs were $8,118 higher for pazopanib-treated patients and $14,343 for sunitinib-treated patients. CONCLUSIONS: The findings suggest that health care costs were lower among patients with advanced RCC treated first-line with pazopanib versus sunitinib. FAU - Hansen, Ryan N AU - Hansen RN AD - University of Washington, Box 357630, Seattle, WA 98195. rhansen@uw.edu. FAU - Hackshaw, Michelle D AU - Hackshaw MD FAU - Nagar, Saurabh P AU - Nagar SP FAU - Arondekar, Bhakti AU - Arondekar B FAU - Deen, Keith C AU - Deen KC FAU - Sullivan, Sean D AU - Sullivan SD FAU - Ramsey, Scott D AU - Ramsey SD LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Manag Care Spec Pharm JT - Journal of managed care & specialty pharmacy JID - 101644425 RN - 0 (Indazoles) RN - 0 (Indoles) RN - 0 (Pyrimidines) RN - 0 (Pyrroles) RN - 0 (Sulfonamides) RN - 7RN5DR86CK (pazopanib) RN - V99T50803M (Sunitinib) SB - IM CIN - J Manag Care Spec Pharm. 2015 Sep;21(9):841-3. PMID: 26308231 CIN - J Manag Care Spec Pharm. 2015 Sep;21(9):844. PMID: 26536677 MH - Carcinoma, Renal Cell/*drug therapy/*economics MH - Female MH - *Health Care Costs MH - Health Services/statistics & numerical data MH - Humans MH - Indazoles MH - Indoles/adverse effects/*economics/therapeutic use MH - Kidney Neoplasms/*drug therapy/*economics MH - Male MH - Middle Aged MH - Pyrimidines/adverse effects/*economics/therapeutic use MH - Pyrroles/adverse effects/*economics/therapeutic use MH - Sulfonamides/adverse effects/*economics/therapeutic use MH - Sunitinib MH - United States PMC - PMC10398249 COIS- Funding for this study was provided by GlaxoSmithKline (GSK). All listed authors meet the criteria for authorship set forth by the International Committee for Medical Journal Editors. Hansen has nothing to declare. Sullivan and Ramsey are employees of VeriTech Corporation, which has received research funding from GSK for activities related to this study. Ramsey has also been a paid consultant on the Value Assessment Committee and has received grant funding from Premera Blue Cross unrelated to this study. Hackshaw, Nagar, Arondekar, and Deen are employees of and hold stock in GSK. The authors (funded by GSK) had a role in the conception and design of the study; collection, analysis, and interpretation of data; and final manuscript approval. Hansen, Hackshaw, Arondekar, Sullivan, and Ramsey contributed equally to study design. Nagar, Deen, Hackshaw, and Arondekar collected the data, which were interpreted by Hansen, Hackshaw, Sullivan, and Ramsey, with assistance from Arondekar, Nagar, and Deen. The manuscript was written by Hansen, Hackshaw, Ramsey, Arondekar, and Sullivan, with assistance from Nagar and Deen. All authors contributed equally to manuscript revision. EDAT- 2015/01/07 06:00 MHDA- 2015/09/15 06:00 PMCR- 2015/01/01 CRDT- 2015/01/07 06:00 PHST- 2015/01/07 06:00 [entrez] PHST- 2015/01/07 06:00 [pubmed] PHST- 2015/09/15 06:00 [medline] PHST- 2015/01/01 00:00 [pmc-release] AID - 2015(21)1: 37-44 [pii] AID - 10.18553/jmcp.2015.21.1.37 [doi] PST - ppublish SO - J Manag Care Spec Pharm. 2015 Jan;21(1):37-44, 44a-d. doi: 10.18553/jmcp.2015.21.1.37.