“The purpose was to assess the cost-effectiveness of sorafenib in the treatment of hepatocellular carcinoma (HCC) patients see more incorporating current prices and the results of the recent published field practice SOraFenib Italian Assessment (SOFIA) study. We created a Markov Decision Model to evaluate, in a hypothetical cohort of Caucasian male patients, aged 67 years with Barcelona Clinic Liver Cancer (BCLC) C HCC, or
BCLC B HCC who were unfit or failed to respond to locoregional therapies, well compensated cirrhosis, and with performance status 0-1 according to Eastern Cooperative Oncology Group (ECOG), the cost-effectiveness of the following strategies:
(1) full or dose-adjusted sorafenib for BCLC B and C patients together; (2) full or dose-adjusted sorafenib for BCLC B patients; (3) full or dose-adjusted sorafenib for BCLC C Carfilzomib cell line patients. Outcomes include quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratio (ICER). In the base-case analysis dose-adjusted sorafenib was the most effective of the evaluated strategies. For dose-adjusted sorafenib, QALY was 0.44 for BCLC B and C patients together, 0.44 for BCLC C patients, and 0.38 for BCLC B patients. The ICER of dose-adjusted sorafenib compared with BSC was €34,534 per QALY gained for BCLC B and C patients together, €27,916 per QALY gained for BCLC C patients, and €54,881 per QALY gained for BCLC B patients. Results were sensitive to BSC survival rate, and sorafenib treatment duration. Conclusion: In daily practice dose-adjusted, but not full-dose, sorafenib is a cost-effective treatment compared to BSC in intermediate and advanced HCC. (HEPATOLOGY 2013) Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide with more than half a million new cases each year with an increasing incidence in the USA and Europe, and contributes substantially
to healthcare spending. Most patients with HCC (∼50%) diagnosed at the Barcelona Clinic Liver Cancer (BCLC) are B (intermediate) and C (advanced) stages. The prognosis is grim for advanced HCC or intermediate learn more HCC patients who are contraindicated for or do not respond to locoablative treatments like transarterial chemoembolization (TACE) or radiofrequency ablation (RFA). 1-3 Sorafenib (Nexavar, Bayer Healthcare Pharmaceuticals-Onyx Pharmaceuticals) is an oral multikinase inhibitor that restrains tumor blood vessel development and tumor cell proliferation. Clinical efficacy data came from the Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) study, which was a registration multicenter, double-blind, placebo-controlled randomized trial in patients with advanced HCC.