Cost and Effectiveness of the use of Sorafenib in Differentiated Thyroid Cancer

Abstract

The prevalence of differentiated thyroid cancer (DTC) locally advanced or metastatic refractory to radioactive iodine (RAI) has been increasing in the past decade. The treatments related to this condition are limited and are associated with substantial direct medical costs, low quality of life and survival. The aim of this study was to estimate the cost and effectiveness of sorafenib administrated in radioiodine-refractory DTC patients in Colombia. MethOds: We adapted a Markov Model to simulate the process of radioiodine-refractory DTC patients treated with sorafenib. Clinical data were obtained from a systematic review. Costs were estimated from a standard costing based on expert panel. The primary outcomes were costs and QALYS. We performed one-way sensitivity analysis as well as probabilistic sensitivity analysis based on Monte Carlo simulation of 1000 iterations to explore the uncertainty of the parameters used in the model. Results: The estimated direct medical cost of DTC-RAI was COP $ 575,512 in ambulatory patients. The standard cost of the disease progression was COP $ 2,481,336 in outpatient and COP $ 10,812,295 in inpatient. The progression free survival was 1.30 months for sorafenib and 0.45 for Best Supportive Care (BSC). The monthly costs of treatments were COP $ 20,510,821 and COP $ 9,138,752 for BSC and Sorafenib, respectively. Treatment with sorafenib resulted in additional gains in terms of effectiveness compared to the BSC option. (0.67 QALYs more than treatment with BSC which reported gains of 1.74 QALYs). Moreover, sorafenib results in cost savings for early progression in COP $ 11,299,586 compared to BSC. cOnclusiOns: Sorafenib is a treatment that delays disease progression. Also, given its cost savings results, is a potentially cost effective treatment option in patients with DTC-RAI in Colombia. PCN35 Estudio dE Costo-EfECtividad E imPaCto PrEsuPuEstal dE dENosumab vs.

Thyroid Cancer in Ecuador, a 16 years population-based analysis (2001–2016)

“…One geographic area where thyroid cancer epidemiology has been underreported is South America. A few countries such as Brazil (1.8/100,000), Colombia (2.1/100,000) or Chile (7.8/100,000) have reported data about their incidence of thyroid cancer, however, the majority of Latin-American countries such as Ecuador, Peru, Bolivia or Paraguay have not reported thyroid cancer trends, incidences or any epidemiological data in the last decade [4–7]. Understanding different trends and epidemiological variability among Latin American countries will offer more information to help us understand the reasons behind the increasing rates of thyroid cancer worldwide.…”