How Do Cost-Effectiveness Analyses Inform Reimbursement Decisions for Oncology Medicines in Canada? The Example of Sunitinib for First-Line Treatment of Metastatic Renal Cell Carcinoma

Chabot, Isabelle; Rocchi, A.

doi:10.1111/j.1524-4733.2010.00738.x

Cited by 38 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of the 20 congress abstracts concerning first-line mRCC treatment, 16 were based on a same model or similar model structure presented in more detail in the full articles [14][15][16].…”

Section: Cost-effectiveness Studies Of New Therapies For Mrccmentioning

confidence: 99%

Cost effectiveness in practice and its effect on clinical outcomes

Ramsey

Wilking

2014

Journal of Cancer Policy

View full text Add to dashboard Cite

a b s t r a c tThe value of new cancer drugs is maximized when they are used for the right patient in the right way in clinical practice. Clinical trials conducted during drug development are the most important source of information to predict value at the time a drug is introduced in practice. Regulatory approval is an indication of value, which lately has been complemented with an assessment of clinical value for decisions about reimbursement, using the methodology of health technology assessment (HTA). Formal cost-effectiveness studies are an important part of this methodology, aiming to assist decisions about value for money in health care spending. The question is if the addition of a complementary HTA and cost-effectiveness study increases the value realized by the drug in practice compared to how it would be used without these assessments.We review the issues involved in providing an answer by using the introduction of new targeted therapies for metastatic renal cell cancer (mRCC). Specifically, we examine the link between clinical trial data and estimations of cost-effectiveness at drug launch, reimbursement decisions, uptake and use in different countries and evidence about impact on outcome in patient populations for which the new drugs are indicated.We conclude that there is a weak link between the assessments used at drug launch and the value created in clinical practice. We suggest measures that are necessary for the achievement of evidencebased and cost-effective cancer care in clinical practice.

show abstract

“…Out of the 20 congress abstracts concerning first-line mRCC treatment, 16 were based on a same model or similar model structure presented in more detail in the full articles [14][15][16].…”

Section: Cost-effectiveness Studies Of New Therapies For Mrccmentioning

confidence: 99%

Cost effectiveness in practice and its effect on clinical outcomes

Ramsey

Wilking

2014

Journal of Cancer Policy

View full text Add to dashboard Cite

show abstract

“…As such, both the costing and the cost-utility analysis work are novel. Because improving care of remote-and rural-dwellers continues to be a high priority for governments around the world (24-26), our results are relevant for decision makers, particularly given that this clinic seems cost-effective by accepted standards, and are markedly lower than for other interventions in common use for patients with (27,28) and without CKD (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Adding Specialized Clinics for Remote-Dwellers with Chronic Kidney Disease

Wiebe

Klarenbach

Chui

et al. 2012

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives This study aimed to determine whether opening a new clinic in a remote region would be a cost-effective means of improving care for remote-dwellers with CKD.Design, setting, participants, & measurements This study is a cost-utility analysis from a public payer's perspective over a lifetime horizon, using administrative data from a large cohort of adults with stage 3b-4 CKD in Alberta, Canada. The association between the distance from each simulated patient's residence and the practice location of the closest nephrologist and clinical outcomes (quality of care, hospitalization, dialysis, and death) were examined. A Markov 6-month cycle economic decision model was analyzed; estimates of the effect of a new clinic were based on the association between residence location, resource use, and outcomes. Costs are reported in 2009 Canadian dollars.Results The costs for equipping and operating a clinic for 321 remote-dwelling patients were estimated at $25,000 and $250,000/yr, respectively. The incremental cost-utility ratios (ICURs) ranged from $4000 to $8000/qualityadjusted life-year under most scenarios. However, if reducing distance to nephrologist care does not alter mortality or hospitalization among remote-dwellers, the cost-effectiveness becomes less attractive. All other one-way sensitivity analyses had negligible effects on the ICUR.Conclusions Given the low costs of equipping and operating new clinics, and the very attractive ICUR relative to other currently funded interventions, establishing new clinics for remote-dwellers could play an important role in efficiently improving outcomes for patients with CKD. High-quality controlled studies are required to confirm this hypothesis.

show abstract

“…These ICERs are below ICER estimates for a 21-GEP assay 59,60 and cancer drugs that were recently recommended for adoption. 61,62 The clinical benefit of 0.28 LY is comparable to several recently approved drugs for metastatic disease. [63][64][65][66] The budget impact analysis shows that adoption of the 2000-GEP testing would lead to total incremental cost of $36.2 million per year.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, when these three groups of parameters were negatively modified by approximately 35% (Figure 2d) the ICER became well above ranges of a number of cancer treatments recently approved for funding in Canada 61,62 and the 2000-GEP-based strategy may no longer deemed a cost effective use of resources. Our value-ofinformation analysis demonstrated that there is a significant societal benefit from future research that can better characterize these three groups of parameters.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary

et al. 2016

View full text Add to dashboard Cite

We aimed to investigate the cost-effectiveness of a 2000-gene-expression profiling (GEP) test to help identify the primary tumor site when clinicopathological diagnostic evaluation was inconclusive in patients with cancer of unknown primary (CUP). We built a decision-analytic-model to project the lifetime clinical and economic consequences of different clinical management strategies for CUP. The model was parameterized using follow-up data from the Manitoba Cancer Registry, cost data from Manitoba Health administrative databases and secondary sources. The 2000-GEP-based strategy compared to current clinical practice resulted in an incremental cost-effectiveness ratio (ICER) of $44,151 per quality-adjusted life years (QALY) gained. The total annual-budget impact was $36.2 million per year. A value-of-information analysis revealed that the expected value of perfect information about the test's clinical impact was $4.2 million per year. The 2000-GEP test should be considered for adoption in CUP. Field evaluations of the test are associated with a large societal benefit.

show abstract

How Do Cost-Effectiveness Analyses Inform Reimbursement Decisions for Oncology Medicines in Canada? The Example of Sunitinib for First-Line Treatment of Metastatic Renal Cell Carcinoma

Abstract: This demonstrates that the cost-effectiveness ratio is only one of many factors that affect an access decision in oncology.

Cited by 38 publications

References 34 publications

Cost effectiveness in practice and its effect on clinical outcomes

Cost effectiveness in practice and its effect on clinical outcomes

Adding Specialized Clinics for Remote-Dwellers with Chronic Kidney Disease

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary

Contact Info

Product

Resources

About