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Economic Burden of Renal Cell Carcinoma

Part I–An Updated Review

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Abstract

The economic burden of renal cell carcinoma (RCC) came into sharp focus when the UK National Institute for Health and Clinical Excellence (NICE) denied coverage (later reversed) of sunitinib for metastatic RCC. In the first of two articles that provide updated reviews and analyses of the economic burden of RCC, we conducted an updated literature review of RCC-related economic studies.

We performed a literature search of PubMed, EMBASE and the Cochrane Library for English-language studies published from 1 January 2000 to 15 June 2010. We also performed a separate search for related studies in the Health Technology Assessment (HTA) reports published by the National Institute for Health Research HTA Programme in the UK. Identified articles were classified into three categories: cost studies, cost-effectiveness/costutility studies and cost-of-illness studies. All cost estimates were normalized to $US, year 2009 values.

We identified 20 articles, including six cost, six cost-utility and eight costof- illness studies. In general, the studies found new surgical techniques, such as laparoscopic partial nephrectomy, to be potentially cost saving (in the range of $US181–5842). Targeted agents, such as bevacizumab, sunitinib, sorafenib and temsirolimus, were associated with higher lifetime costs ($US8537–72254) and were not always considered to be cost effective by authors of the cost-effectiveness studies included in this review (incremental cost-effectiveness ratio [ICER]: $US49 959–272 418 per QALY). The literature reported annual estimates of the US economic burden of RCC between $US0.60 billion and $US5.19 billion, with per-patient costs of $US16 488–43805.

RCC is associated with substantial economic burden, although the estimates are wide ranging. Comparisons of the estimates across studies were hindered by variations in study methodology, choice of database and the associated timeframe, and limitations inherent to each database. More research is needed to assess the quality of the economic studies of RCC and to understand why the estimated costs differ across studies.

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Acknowledgements

This research was partially funded by a grant from the Agency for Healthcare Research and Quality (AHRQ, R01 HS018535) to Ya-Chen Tina Shih, and a grant from the China Medical University Hospital, Taiwan (DMR-98-132) and a grant from the Department of Health, Taiwan (DOH99-TD-C-111005) to Chun-Ru Chien. The authors thank Ms LeeAnn Chastain for her editorial contributions. The interpretation and reporting of these data are the responsibilities of the authors and in no way should be viewed as an official policy or interpretation of the AHRQ.

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Authors and Affiliations

  1. Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Ya-Chen T. Shih (Associate Professor), Ying Xu & I-Wen Pan

  2. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan

    Chun-Ru Chien

  3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Grace L. Smith & Thomas A. Buchholz

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  1. Ya-Chen T. Shih
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Correspondence to Ya-Chen T. Shih.

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Shih, YC.T., Chien, CR., Xu, Y. et al. Economic Burden of Renal Cell Carcinoma. Pharmacoeconomics 29, 315–329 (2011). https://doi.org/10.2165/11586100-000000000-00000

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