Background: Axitinib has been suggested to be effective as a second line treatment of metastatic renal cell carcinoma. However, its adoption may be limited by its financial consequences. Therefore, a cost-utility analysis was conducted to estimate the economic value of axitinib as a second line treatment of metastatic renal cell carcinoma. Aim: This analysis will informed the decision makers on the potential use of axitinib in this population within the Ministry of Health facilities. Methods: A state transition model was developed using Microsoft Excel 2010 to simulate a hypothetical cohort of patient receiving axitinib or best supportive care over 5 years of time horizon. A monthly cycle was chosen without a half cycle correction. Three health states were included in the model as progression free, disease progression and dead. A 3% discount rate was applied as recommended in the Pharmacoeconomic Guidelines for Malaysia. Total costs were estimated using unit costs from local sources and published data. The clinical and utility parameters were derived from the published literatures. Results: The mean probabilistic incremental discounted cost and QALY for axitinib were RM 113,576.29 and 0.35413 respectively, yielded a probabilistic incremental cost-effectiveness ratio (ICER) of RM 320,719. Unavailability of the local price for axinitib may play a part in the higher estimation of ICER. Conclusion: Axitinib may not be considered as a cost-effective second line treatment of metastatic renal cell carcinoma as the ICER is beyond the value of 3 GDP per capita.
Cost-Effectiveness of Pazopanib Versus Sunitinib in Egyptian Patients with Metastatic Renal Cell Carcinoma From the Health Insurance Perspective: A Markov Model
