Cost-effectiveness of @entity4381 in the management of skeletal @entity3 in XXXX with lung cancer in France, Germany, Portugal, the Netherlands, and the United kingdom.

@entity5921 @entity1 @entity5 @entity1149 @entity3 @entity4381
BACKGROUND: @entity4381 ( @entity5921 ) significantly reduces the risk of new skeletal-related events (SREs) in @entity1 with @entity1149 ( @entity1149 ) who have bone @entity3 . OBJECTIVE: The purpose of this study was to assess the cost and cost-effectiveness of @entity5921 in the management of skeletal @entity3 in this population across 5 European countries (France, Germany, United Kingdom, Portugal, and the Netherlands) from the perspective of national health care. METHODS: This cost-effectiveness analysis was based on a subset of @entity1 with @entity1149 who were enrolled in a Phase III trial of @entity1 with bone @entity3 secondary to a variety of solid @entity5 . In this trial, @entity1 were randomized to receive @entity5921 or placebo every 3 weeks for up to 21 months. Survival, SRE incidence, and number of infusions administered were derived from the clinical trial. Costs of SREs were estimated using hospital Diagnosis Related Group tariffs and published data. Drug, drug administration, and supply costs were obtained from published and internet sources. Quality-adjusted life-years (QALYs) were estimated based on the published utilities and modeled survival and frequency of SREs. Uncertainty surrounding outcomes was addressed via univariate and probabilistic sensitivity analyses. RESULTS: Compared with @entity1 receiving placebo (n = 120), @entity1 receiving @entity5921 (n = 124) experienced an estimated 0.79 fewer SREs and gained an estimated 0.02 QALYs. @entity5921 use in @entity1 with @entity1149 and bone @entity3 was associated with a reduction in SRE costs (ranging from    1547 to    1893 [2007-2008    ], depending on the country). After adding drug and drug administration costs, @entity5921 use resulted in a net savings of    288 per @entity1 in Germany,    209 in the United Kingdom, and    113 in Portugal. In France and the Netherlands, costs increased (   17 and    178, respectively), but the costs per QALY gained were low (   786 and    8278, respectively). In univariate sensitivity analyses, the cost per QALY for @entity5921 versus placebo was  <=   50,000 for all scenarios tested. The results were most sensitive to assumptions regarding survival, number of @entity5921 infusions, and the costs of SREs. The probabilistic sensitivity analysis indicated that @entity5921 cost  <=   50,000 per QALY in 65% to 83% of model simulations (depending on country). However, some degree of uncertainty remained as the 95th percentile of cost per QALY was high. CONCLUSIONS: This analysis is subject to the usual limitations of cost-effectiveness models, which combine assumptions and data from multiple sources. Nevertheless, based on the assumptions used herein, the present model suggests that @entity5921 increases QALYs and is cost saving and/or cost effective compared with placebo in @entity1 with @entity1149 in France, Germany, the United Kingdom, Portugal, and the Netherlands.
