First line treatment for metastatic renal cell carcinoma in Colombia : a cost-effectiveness analysis.

Tratamiento de primera línea para el carcinoma de células renales metastásico en Colombia : un análisis de costo-efectividad.

Published 2012-09-01

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Vol. 1 No. 3 (2012): Septiembre
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First line treatment for metastatic renal cell carcinoma in Colombia : a cost-effectiveness analysis.
Rev. colomb. hematol. oncol. [Internet]. 2012 Sep. 1 [cited 2024 Dec. 22];1(3):15-23. Disponible en: https://doi.org/10.51643/22562915.310
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Andrés Felipe Cardona
Fundación Santa Fe de Bogotá
    Javier Godoy
    Hospital Militar Central
      Heidy Cáceres
      Pfizer
        Jorge Miguel Otero
        Fundación Santa Fe de Bogotá
          Mauricio Luján
          Clínica de oncología Astorga ; Universidad Pontificia Bolivariana
            Show authors biography

            Andrés Felipe Cardona,

            Clinical and Translational Oncology Group, Institute of Oncology, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Javier Godoy,

            Hematology and Oncology Department, Hospital Militar Central (Bogotá, Colombia).

            Heidy Cáceres,

            Pfizer Medical Division (Bogotá, Colombia).

            Jorge Miguel Otero,

            Clinical and Translational Oncology Group, Institute of Oncology, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Foundation for Clinical and Translational Cancer Research (FICMAC); associated researcher ONCOLGroup.

            Mauricio Luján,

            Medical Oncology Department, Clínica de Oncología Astorga (Medellín, Colombia). Medical Faculty, Universidad Pontificia Bolivariana (Medellín, Colombia).

            Diego Lopera,

            Medical Oncology Department, Oncólogos de Occidente (Manizales, Colombia).

            Javier Pacheco,

            Medical Oncology Department, Hospital de San José, Fundación Universitaria Ciencias de la Salud (Bogotá, Colombia).

            Alfredo Spath,

            Pfizer Medical Division (Bogotá, Colombia).

            Hernán Carranza,

            Clinical and Translational Oncology Group, Institute of Oncology, Fundación Santa Fe de Bogotá (Bogotá, Colombia). Foundation for Clinical and Translational Cancer Research (FICMAC); associated researcher ONCOLGroup.

            Henry Becerra,

            Clinical and Translational Oncology Group, Institute of Oncology, Fundación Santa Fe de Bogotá (Bogotá, Colombia).

            Paul Gis,

            Medical Faculty, Universidad Nueva Granada (Bogotá, Colombia).

            Objective: To perform a local study based on an economic evaluation of first-line treatment of metastatic renal cell carcinoma in Colombia, since 2006-2007. Methods: We developed a Markov model using 6-week cycles to evaluate the cost-effectiveness of 4 interventions (IFN, sunitinib, bevacizumab + IFN, sorafenib) used as standard first-line treatment for mRCC in Colombia. The model used the thirdparty payer perspective and a 10-year time-line with all patients continuing with active treatment until progression, when it became acceptable to proceed to a second-line treatment or best supportive care (BSC). Results: Incremental analysis indicated a difference of US$21.796 in the average total cost of treatment when sunitinib was compared to IFN. Opposite, comparing sorafenib and bevacizumab + IFN to sunitinib demonstrated that the average total cost was less for sunitinib by US$25.857 and US$110.947 respectively. The ratios of incremental cost-effectiveness by life years gained (LYG) demonstrated sunitinib’s cost saving compared to sorafenib and the combination of bevacizumab + IFN, and an average by LYG of US$50.564,25 compared to IFN. Uncertainy is principally about sample size analized for Colombian population data. Conclusions: Sunitinib was the most cost-effective option as first-line treatment for mRCC patients in Colombia (2006- 2007), compared with the other available options. Current pharmacoeconomic data is important to improve knowledge and define the best sequence model to treat this disease in our country.

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            1. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356(2):115-24.
            2. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281(17):1628-31.
            3. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331-4.
            4. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer Statistics, 2007. CA Cancer J Clin. 2007;57(1):43-66.
            5. Motzer RJ, Figlin RA, Hutson TE, Tomczak P, Bukowski RM, Rixe O, et al. Sunitinib versus interferon-alfa (IFN) as first-line treatment of metastatic renal cell carcinoma (mRCC): Updated results and analysis of prognostic factors. J Clin Oncol. 2007 ASCO Annual Meeting Proceedings Part I. 2007;25(18S):5024.
            6. Adams VR, Leggas M. Sunitinib malate for the treatment of metastatic renal cell carcinoma and gastrointestinal stromal tumors. Clin Ther 2007;29(7):1338-53.
            7. Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, et al., editors. SEER Cancer Statistics Review, 1975- 2005. Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER web site, 2008.
            8. Wünsch-Filho V. Insights on diagnosis, prognosis and screening of renal cell carcinoma. Sao Paulo Med J. 2002;120(6):165-4.
            9. Salvadó JA, Domínguez J, Velasco A, Bustamente A, Troncoso P, Pinochet R, et al. Factores pronósticos en carcinoma de células renales: ¿son adecuadas las variables definidas por el actual TNM? Rev Chil Urol. 2006;71(2):141-46.
            10. Mirra AP, Latorre MRDO, Veneziano DB (eds.). Cancer incidence in the city of São Paulo, Brazil, 1997-1998. Cancer mortality in the city of São Paulo, Brazil. Trends in the period 1969-1998. Brasília, DF: Ministério da Saúde; 2001.
            11. Rini BI, Campbell SC, Rathmell WK. Renal cell carcinoma. Curr Opin Oncol. 2006;18(3):289-96.
            12. Halbert RJ, Figlin RA, Atkins MB, Bernal M, Hutson TE, Uzzo RG, et al. Treatment of patients with metastatic renal cell cancer: a RAND Appropriateness Panel. Cancer. 2006;107(10):2375-83.
            13. Pouessel D, Culine S. Targeted therapies in metastatic renal cell carcinoma: the light at the end of the tunnel. Expert Rev Anticancer Ther. 2006;6(12):1761-7.
            14. Orozco JM. Los costos del plan obligatorio de salud subsidiado en Colombia. 2006. URL available from: (accessed in June 2012).
            15. Globocan 2000. Lyon: International Agency for Research on Cancer; 2000. URL available from: (accessed in June 2012).
            16. Murillo R, Quintero A, Piñeros M, Bravo MM, Cendales R, Wiesner C, et al. Modelo para el control del cáncer en Colombia. URL available from: (accessed in June 2012).
            17. Martínez F, Robayo G, Valencia O. Desarrollo del principio de universalidad en el Sistema General de Seguridad Social en Salud: a ocho años de la reforma en Colombia. Acemi, Fedesalud; 2002. URL available from: (accessed in June 2012).
            18. Allareddy V, Konety BR. Inpatient costs for bladder, kidney, and prostate cancers in the year 2002. A study using the NIS sample. American Urological Association Annual Meeting, May 20-25, 2006. Abstract 232.
            19. Lefebvre C, Lusher A, Dickersin K, Manheimer E. Literature searches. Lancet. 2002;359(9309):896.
            20. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Oudard S, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009;27(22):3584-90.
            21. Negrier S, Escudier B, Lasset C, Douillard JY, Savary J, Chevreau C, et al. Recombinant human interleukin-2, recombinant human interferon alfa-2a, or both in metastatic renal-cell carcinoma. Groupe Francais d’Immunotherapie. N Engl J Med. 1998;338(18):1272-8.
            22. Szczylik C, Demkow T, Staehler M, Rolland F, Negrier S, Hutson TE, et al. Randomized phase II trial of first-line treatment with Sorafenib versus interferon in patients with advanced renal cell carcinoma: Final results. J Clin Oncol. 2007;25(18S):5025.
            23. Escudier B, Bellmunt J, Négrier S, Bajetta E, Melichar B, Bracarda S, et al. Phase III trial of bevacizumab plus interferon alfa-2a in patients with metastatic renal cell carcinoma (AVOREN): final analysis of overall survival. J Clin Oncol. 2010;28(13):2144-50.
            24. Remák E, Charbonneau C, Négrier S, Kim ST, Motzer RJ. Economic evaluation of sunitinib malate for the first-line treatment of metastatic renal cell carcinoma. J Clin Oncol. 2008;26(24):3995-4000.
            25. Weibull W. A statistical distribution function of wide applicability. J Appl Mech Trans ASME. 1951;18(3):293-7.
            26. Godoy JI, Cardona AF, Alvis N, Arango CH, Romero C, Spath A, et al. Sunitinib vs. interferon-alfa (IFN) for first-line treatment of metastatic renal cell carcinoma (mRCC) in Colombia: an economic evaluation. Rev Colomb Cancerol. 2008;12(2):63-73.
            27. Commission on Macroeconomics and Health, World Health Organization (WHO). Macroeconomics and health: investing in health for economic development. Geneva: World Health Organization; 2001.
            28. Trippoli S, Messori A. Cost effectiveness of sunitinib. J Clin Oncol. 2008;26(35):5829.
            29. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Oudard S, et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009;27(22):3584-90.
            30. Heng DY, Chi KN, Murray N, Jin T, Garcia JA, Bukowski RM, et al. A population-based study evaluating the impact of sunitinib on overall survival in the treatment of patients with metastatic renal cell cancer. Cancer. 2009;115(4):776-83.
            31. Chabot I, LeLorier J, Blackstein ME. The challenge of conducting pharmacoeconomic evaluations in oncology using crossover trials: the example of sunitinib for gastrointestinal stromal tumour. Eur J Cancer. 2008;44(7):972-7.
            32. Gill S, Sargent D. End points for adjuvant therapy trials: has the time come to accept disease-free survival as a surrogate end point for overall survival? Oncologist 2006;11(6):624-9.
            33. Negrier S, Figlin RA, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, et al. Overall survival with sunitinib versus interferon (IFN)-alfa as first-line treatment of metastatic renal cell carcinoma (MRCC). European Society Medical Oncology (ESMO) 2008. Abstract 588.
            34. Bukowski RM, Eisen T, Szczylik C, Stadler WM, Simantov R, Shan M, et al. Final results of the randomized phase III trial of sorafenib in advanced renal cell carcinoma: Survival and biomarker analysis. J Clin Oncol. 2007;(May 20 suppl). Abstract 5023.
            35. Coppin C, Le L, Porzsolt F, Wilt T. Targeted therapy for advanced renal cell carcinoma. Cochrane Database Syst Rev. 2008;(2):CD006017.
            36. Benedict A, Charbonneau C, Kim ST, Négrier S. Cost-effectiveness of sunitinib, sorafenib, temsirolimus, and bevacizumab + interferon-alfa as first-line therapy for metastatic renal cell carcinoma: an indirect comparison. European Society Medical Oncology (ESMO) 2008. Abstract 723.
            37. Benedict A, Charbonneau C, Hidi J, Kim ST, Négrier S. Economic evaluation of sunitinib, sorafenib, bevacizumab/interferon-alfa and temsirolimus for first line treatment of metastatic renal cell carcinoma (mRCC): a cost-effectiveness analysis. J Clin Oncol. 2008;(May 20 suppl). Abstract 5048.
            38. Díaz S, Calvo Aller E, Maroto P, Puente J, López-Brea M, Castellano D. Cost-effectiveness and cost-utility analysis of sunitinib vs. sorafenib and bevacizumab + interferon-alfa as firstline treatment for metastatic renal cell carcinoma in Spain. European Society Medical Oncology (ESMO) 2008. Abstract 724.
            39. Munir U, Benedict A, Borgman B, Sandin R, Harmenberg U, Ullén A, et al. Cost-effectiveness of sunitinib vs. sorafenib, temsirolimus and bevacizumab + interferon-alfa as first-line therapy for metastatic renal cell carcinoma - Adaptation for the Swedish Health Service. European Society Medical Oncology (ESMO) 2008. Abstract 725.
            40. Procopio G, Verzoni E, Bajetta E, Giuliani G, Peccerillo C, Walzer S, et al. Cost of managing side effects in the treatment of first-line metastatic renal cell carcinoma in Italy: bevacizumab + interferon alpha-2ª compared with sunitinib. Ann Oncol. 2008;(Oct 20 suppl.). Abstract 601.
            41. Mickisch G, Escudier BJ, Gore ME, Walzer S, Sabaté E, Nuijten M. Costs of managing side effects in the treatment of first-line metastatic renal cell carcinoma (mRCC) in Germany, France, and UK: Bevacizumab (BEV) + interferon alpha-2a (IFN) compared with sunitinib. J Clin Oncol. 2008;26(May 20 suppl). Abstract 5110.
            42. Bukowski RM, Eisen T, Szczylik C, et al. Final results of the randomized phase III trial of sorafenib in advanced renal cell carcinoma: survival and biomarker analysis. 2007 ASCO Annual Meeting Proceedings Part I. J Clin Oncol. 2007;25(18S):5023.

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