Sysematic review of economic evaluation of the first line treatment for metastasis renal cell carcinoma (mRCC)

Abstract

mRCC is the unmet medical need and current treatment with interferon can yield a modest result in term of progression free survival (PFS) and overall survival (OS). Although the Food and Drug Administration has granted fast track approval for new targeted therapy for mRCC, the cost-effectiveness information of these agents is required by healthcare decision makers and providers and has been still limited. To systematically review the economic evaluation of published literature of tyrosine kinase inhibitors, mTOR inhibitors against comparator under licensed indications. The electronic databases from Pubmed, Cochrane Library and Embase were searched from 2000 to 2010. The economic evaluation studies of the first line mRCC treatments were included in the review. The total of 77 articles was retrieved and 68 articles were excluded. Nine articles were included and one was obtained from hand searching, thus ten articles were synthesized. Healthcare provider perspective and Markov model were used in all studies. Cost-utility analysis was conducted in seven studies, while cost-effectiveness analysis was performed in two studies. Treatment costs in all studies were retrieved from local published data and retrospective chart review. Eight studies showed that Sunitinib seemed to be more cost-effective compared with other targeted therapie. Bevacizumab plus interferon was considered to be less costly compared to sunitinib due to less cost of adverse event in one study. However, the implications might be used with caution due to QALY threshold and budget impact.