Objectives: The objective of this evaluation was to assess cost-effectiveness of pegfilgrastim compared to filgrastim when used as prophylaxis in subsequent chemotherapy cycles for patients who experience a neutropenic event (NE; absolute neutrophil count < 500/m3), consistent with Turkish regulatory indication. Pegfilgrastim was compared to filgrastim (5 days) for reducing incidence of FN events in patients receiving cytotoxic chemotherapy for solid tumors in Turkey. MethOds: An economic model was developed to assess cost-effectiveness of pegfilgrastim compared to filgrastim given for 5 days per cycle (short course based on Turkish clinical practice) in breast cancer patients receiving highly myelotoxic (≥ 20% FN risk) or moderately myelotoxic (10-20% FN risk) chemotherapy regimens. A Markov cycle tree was modeled comprising two components: a decision tree that tracks initial chemotherapy cycle and associated NE events, and a Markov model consisting of two phases. Phase 1 tracks FN events in subsequent chemotherapy cycles following an NE, while Phase 2 tracks long-term cancer-related survival. All analyses were performed from the payer perspective and included direct health care costs only. A lifetime time horizon was considered. Deterministic sensitivity analyses were conducted on key model parameters. Results: The average cost of treating an FN episode for a solid tumor was calculated as TRY8900[$4070] based upon consultation with Turkish clinicians. For highly myelotoxic regimens, switching to prophylaxis with pegfilgrastim after an NE was a dominant strategy (incremental cost: TRY-99 [$-45], incremental QALY: 0.03). ICER for medium myelotoxic regimens was TRY7920[$3622] (incremental cost: TRY55[$25], incremental QALY: 0.01); highly cost-effective based on WHO-recommended ICER threshold (GDP per capita = TRY22718[$10390]). Cost-effectiveness results were robust to deterministic changes in key model parameters (e.g. risk of FN in subsequent cycles, cost of FN). cOnclusiOns: Prophylaxis with pegfilgrastim for reducing incidence of FN after a first NE is either dominant or cost-effective compared to filgrastim (5 days).Objectives: Considering the increasing number of treatment options for metastatic breast cancer (MBC), it is important to develop high-quality methods to assess the cost-effectiveness of new anticancer drugs. This study aims to develop a global economic model that could be used as a benchmark for the economic evaluation of new therapies for MBC. MethOds: The Global Pharmacoeconomics of Metastatic Breast Cancer (GPMBC) model is a Markov model that was constructed to estimate the incremental cost per quality-adjusted life years (QALY) of new treatments for MBC from a Canadian healthcare system perspective over a lifetime horizon. Specific parameters included in the model are cost of drug acquisition, survival outcomes, and incidence of treatment-related adverse events (AEs) whereas global parameters are patient characteristics, health states utilities, disutilities and costs associated with treatmen...

Objectives: Encompassing a group of cancers originating from the upper aerodigestive tract, head and neck cancers are ranked in the top ten for both incidence and mortality among all malignancies globally. This study aimed to estimate trends in total secondary care costs associated with the treatment of head and neck cancers in England from 2006/2007 to 2010/2011. MethOds: Data on inpatient and outpatient activity associated with oropharyngeal, oral cavity and laryngeal cancer was extracted from the Hospital Episode Statistics (HES) database. After grouping inpatient episodes into spells, a single Healthcare Resource Group (HRG) was derived for each and then cross-referenced with the National Tariff 2010/11 to estimate the associated cost. For specific types of therapy, including chemotherapy and radiotherapy, HRG definitions were cross-referenced with the National Reference Costs for the latest available year and inflated using the PCI index. Outpatient costs were estimated by grouping consultations by treatment speciality. Results: The total cost of treatment for all cancers over the entire period was estimated to be around £309 million, at 2011 prices. Inpatient care covered by bundled HRGs accounted for over 90% of this cost, at £280 million. Total costs due to oropharyngeal cancer were slightly higher than those estimated for laryngeal and oral cancer, costing £115 million (37.06%), £96 million (31.15%) and £98 million (31.79%) respectively. There was, generally, an increasing trend in the secondary care burden of all three cancers. Annual costs and patient numbers increased the most for oropharyngeal cancer, with annual inpatient costs increasing from £16,576,046 in 2006/07 to £28,467,016 in 2010/11. cOnclusiOns: This study indicates that there is a significant, and increasing, health and economic burden associated with head and neck cancers in England, highlighting the need for preventative programmes.

A707models. ConClusions: The specified mapping algorithms from the BDI index to the EQ-5D-3L index for patients with depressive disorders are acceptable for usage as approximation in cost-utility analyses. A further validation in independent samples is necessary to obtain more confidence in their performance.

BackgroundMetastatic breast cancer (MBC) is associated with poor prognosis, particularly for those patients with human epidermal growth factor receptor (HER2)-negative tumor. Similar to the rest of the world, treatment options are limited in South Korea following first-line chemotherapy with anthracyclines and/or taxanes. This study examined the cost-effectiveness and cost-utility of eribulin in South Korean patients with HER2-negative MBC who have progressed after usage of at least one chemotherapeutic regimen for advanced disease (second-line therapy).MethodsA partition survival model was developed from the perspective of the South Korean health care system. The economic impact of introducing eribulin as second-line therapy for HER2-negative MBC was compared to that of capecitabine and vinorelbine. The analysis estimated incremental cost per life-year (LY), that is, cost-effectiveness, and cost per quality-adjusted life-year (QALY), that is, cost-utility, of eribulin for management of HER2-negative MBC in South Korea. The model accounted for overall survival, progression-free survival, drug costs, grade 3/4 adverse events, and health care utilization. Deterministic and probabilistic sensitivity analyses were performed to identify uncertainty in the results of the economic evaluation.ResultsSecond-line eribulin was associated with greater benefits in terms of LY and QALY, compared to capecitabine and vinorelbine. The incremental cost-effectiveness ratio was ₩10.5M (approximately USD 9,200) per LY, and the incremental cost-utility ratio was ₩17M (approximately USD 14,800) per QALY in the basecase analysis. The incremental cost-utility ratio ranged from ₩12M (USD 10,461) to ₩27M (USD 23,538) per QALY in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, >99% of the simulations were below ₩50M (USD 42,300), and the lower and upper 95% confidence intervals were ₩3M (USD 2,600) and ₩24M (USD 20,900) per QALY, respectively.ConclusionThere currently exist a limited number of treatment choices for women with HER2-negative MBC. Eribulin is a cost-effective option for second-line therapy in South Korea and should be added to the current indications for reimbursement.

27 Background: Renal cell carcinoma (RCC) is the most common type of kidney cancer and represents about 90% of all kidney cancers. As comprehensive comparison of the efficacy associated with mRCC treatments is not available, the goal of this research was to provide a comparative effectiveness analysis including overall survival (OS) and progression free survival (PFS) for first and second line treatments. Methods: Systematic literature review yielded the following randomized active-controlled studies: lenvatinib + everolimus (LEN+EVE) versus everolimus (EVE), axinitib (AXI) versus sorafenib (SOR), cabozantinib (CAB) versus EVE, nivolumab (NIV) versus EVE, and pazopanib (PAZ) versus sunitinib (SUN). In addition, placebo-controlled studies were identified for EVE, PAZ, and SOR. An indirect treatment comparison (ITC) was performed on OS and PFS hazard ratios (HR). Results: Scenario A presents the HR and confidence intervals (95% CI) generated with ITC of all treatments against EVE. In scenario B, the HR of LEN + EVE are compared to all treatment options. Only LEN + EVE and CAB demonstrated significance against EVE for both OS and PFS. LEN + EVE proved to be significant against EVE, PAZ, SOR, SUN, AXI and NIV for PFS and against EVE, SOR and AXI for OS. The use of crossover trials in the network for the treatment compared to placebo remains a potential bias in the results. Conclusions: Even if limitations exist regarding the use of ITC, the option of LEN+EVE demonstrated a strong comparative effectiveness profile for both OS and PFS. [Table: see text]