[Economic evaluation of targeted biologic therapy in metastatic XXXX ].

@entity1 @entity2240 @entity5 @entity2857 @entity13089 @entity1358 @entity1726 @entity204 @entity7634
BACKGROUND: Targeted biologic therapy has been proven to be effective compared to the current therapy of metastatic @entity1358 (mRCC) in clinical studies as well as in actual clinical practice, but its high cost is a potentially limiting factor. Since the local cost-effectiveness analysis is missing, we assessed the cost of @entity2240 and @entity2857 in the treatment of mRCC in a comprehensive @entity5 centre. @entity1 AND METHODS: A total of 31 @entity1 were treated with @entity2240 and/or @entity2857 between 06/2006 and 09/2009 and then followed for at least 12 months. Clinical (disease progression, adverse events, dose reduction) and cost data (medication, examination, hospitalization) were assessed in the comprehensive @entity5 centre (1 @entity7634 = 25.78 CZK). RESULTS: The multikinase inhibitors were the second line treatment for most @entity1 after @entity13089 therapy failure (86.7%). The mean cost per month to progression ( @entity1726 ) was 94,141.8 CZK/3651.7 @entity7634 ( @entity2240 : 11 months to @entity1726 , cost to @entity1726 1,267,648.5 CZK/49,171.8 @entity7634 ; @entity2857 : 8 months to @entity1726 , cost to @entity1726 896,670.1 CZK / 34,781.6 @entity7634 ). The incremental cost-effectiveness ratio was 123,659.5 CZK / 4796.7 @entity7634 per progression-free month in @entity2240 vs @entity2857 @entity1 . The mean cost per month after @entity1726 was 45,767.0 CZK/1775.3 @entity7634 with sequential therapy ( @entity2857 after @entity2240 failure and vice-versa in more than half of @entity1 ) or best supportive care. 16 @entity1 died during the study period with mean cost of 1,180,795.4CZK/45,802.8 @entity7634 per 12 months (median between treatment initiation with @entity2240 or @entity2857 and @entity204 ). 8 @entity1 (26%) did not achieve progression (median progression-free survival to 09/2009: @entity2240 18 months, @entity2857 14 months). CONCLUSION: The cost of medication made up more than 95% of total costs to @entity1726 and more than 90% after @entity1726 . The cost per progression-free month was 123,659.5 CZK/4796.7 @entity7634 in mRCC @entity1 treated with @entity2240 vs @entity2857 .
