A cost-effectiveness analysis of sunitinib in patients with metastatic renal cell carcinoma intolerant to or experiencing disease progression on immunotherapy: perspective of the Spanish National Health System

P>Aim: To investigate the cost-effectiveness of sunitinib (50 mg/day, schedule 4/2) vs. best supportive care (BSC) in patients with cytokine-refractory metastatic renal cell carcinoma (mRCC), from the perspective of the Spanish National Health Service. Material and Methods: A Markov model compared the cost-effectiveness (taking into account drugs; medical visits; laboratory tests; X-rays; terminal care; adverse event management) of sunitinib and BSC across three disease states: no progression, survival with progression and death from mRCC or other causes. Results: The monthly incremental cost-effectiveness ratio (ICER) values for sunitinib treatment were euro6073/progression-free survival month, euro25 199/life years and euro34 196/quality-adjusted life years (QALY) gained. In 95% of cases, the ICER/QALY values were below the accepted euro45 000/QALY threshold. Efficacy and cost of sunitinib had the greatest impact on cost-effectiveness. Conclusion: Sunitinib has a good cost-effectiveness profile in mRCC. The cost per life year and QALY gained is affordable according to current effectiveness thresholds in developed countries.