A cost analysis of sorafenib for desmoid tumors

Johns, Michael S.; Merritt, William T.; Rhodes, Lori; Ford, Candice N.; Thompson, Mark; Lee, William M.; Sheldon, Yarrow; Petrelli, Nicholas J.; Tiesi, Gregory J.

doi:10.1177/10781552221077927

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	A cost analysis of sorafenib for desmoid tumors
Authors:	Johns, Michael S. Merritt, William T. Rhodes, Lori Ford, Candice N. Thompson, Mark Lee, William M. Sheldon, Yarrow Petrelli, Nicholas J. Tiesi, Gregory J.
et. al:	No
DOI:	10.1177/10781552221077927
Published in:	Journal of Oncology Pharmacy Practice
Issue Date:	3-Feb-2022
Publisher / Ed. Institution:	Sage
ISSN:	1078-1552 1477-092X
Language:	English
Subjects:	Desmoid tumor; Cost analysis; Oncology; Sorafenib
Subject (DDC):	615: Pharmacology and therapeutics 616: Internal medicine and diseases
Abstract:	Introduction: A recent randomized trial demonstrated that sorafenib improved progression free survival (PFS) in patients with desmoid tumors despite many patients experiencing stable disease or spontaneous regression without treatment. Utilizing these trial data, we performed a cost analysis of sorafenib efficacy through two years of treatment. Methods: Current Medicare Part D rates for sorafenib were utilized (dose 400 mg/day, cost $309/day). Annual costs per progression and objective response were calculated. Radiologic progression and response were defined using RECIST criteria. Patients with disease progression were separately analyzed in two groups: both clinical and radiologic (CAR), and radiologic alone. Results: 84 previously randomized patients were analyzed (placebo: 35, sorafenib: 49). At one year, sorafenib was associated with a 43% absolute risk reduction (ARR) of CAR progression and number-needed-to-treat (NNT) of 2.3 patients/year, costing $259,406. At two years, ARR was 48% and NNT of 2.1 patients/year, costing $473,697. When evaluating only patients with RECIST defined radiologic progression, sorafenib patients experienced ARR of 13.9% with NNT 7.2 and estimated costs of $812,052 at one year. Two-year ARR was 17.5% with NNT 5.7 and estimated costs $1,285,052. Sorafenib patients experienced improved RECIST partial response rates at 1 and 2 years of 14.7% and 14.3%, with NNT 6.8 and 6.9, and costs of $766,938 and $1,556,433; respectively. Conclusion: For the treatment of desmoid tumors, Sorafenib led to improved PFS, but at a significant cost per patient. Favorable RECIST outcomes were less likely and costlier. Patients should be informed of possible benefits of treatment versus potential financial burden.
URI:	https://digitalcollection.zhaw.ch/handle/11475/24912
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Management and Law
Organisational Unit:	Institute of Wealth & Asset Management (IWA)
Appears in collections:	Publikationen School of Management and Law

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Johns, M. S., Merritt, W. T., Rhodes, L., Ford, C. N., Thompson, M., Lee, W. M., Sheldon, Y., Petrelli, N. J., & Tiesi, G. J. (2022). A cost analysis of sorafenib for desmoid tumors. Journal of Oncology Pharmacy Practice. https://doi.org/10.1177/10781552221077927

Johns, M.S. et al. (2022) ‘A cost analysis of sorafenib for desmoid tumors’, Journal of Oncology Pharmacy Practice [Preprint]. Available at: https://doi.org/10.1177/10781552221077927.

M. S. Johns et al., “A cost analysis of sorafenib for desmoid tumors,” Journal of Oncology Pharmacy Practice, Feb. 2022, doi: 10.1177/10781552221077927.

JOHNS, Michael S., William T. MERRITT, Lori RHODES, Candice N. FORD, Mark THOMPSON, William M. LEE, Yarrow SHELDON, Nicholas J. PETRELLI und Gregory J. TIESI, 2022. A cost analysis of sorafenib for desmoid tumors. Journal of Oncology Pharmacy Practice. 3 Februar 2022. DOI 10.1177/10781552221077927

Johns, Michael S., William T. Merritt, Lori Rhodes, Candice N. Ford, Mark Thompson, William M. Lee, Yarrow Sheldon, Nicholas J. Petrelli, and Gregory J. Tiesi. 2022. “A Cost Analysis of Sorafenib for Desmoid Tumors.” Journal of Oncology Pharmacy Practice, February. https://doi.org/10.1177/10781552221077927.

Johns, Michael S., et al. “A Cost Analysis of Sorafenib for Desmoid Tumors.” Journal of Oncology Pharmacy Practice, Feb. 2022, https://doi.org/10.1177/10781552221077927.