Evidence map›Paper›PMID 27665470›Full record

ArticleClinical drug investigation2017

Cost-Effectiveness Analysis of Tyrosine Kinase Inhibitors for Patients with Advanced Gastrointestinal Stromal Tumors.

Virginie Nerich, Camille Fleck, Loïc Chaigneau, Nicolas Isambert, Christophe Borg, Elsa Kalbacher, Marine Jary, Pauline Simon, Xavier Pivot, Jean-Yves Blay and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Clinical drug investigation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Virginie NerichDepartment of Pharmacy, University Hospital, Boulevard Fleming, 25030, Besançon Cedex, France. v1nerich@chu-besancon.fr.
Camille FleckDepartment of Pharmacy, University Hospital, Boulevard Fleming, 25030, Besançon Cedex, France.
Loïc ChaigneauDepartment of Medical Oncology, University Hospital, Besançon, France.
Nicolas IsambertDepartment of Medical Oncology, Centre Georges François Leclerc, Dijon, France.
Christophe BorgUniversity Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur - Ingénierie Cellulaire et Génique, Besançon, France.
Elsa KalbacherDepartment of Medical Oncology, University Hospital, Besançon, France.
Marine JaryDepartment of Medical Oncology, University Hospital, Besançon, France.
Pauline SimonDepartment of Pediatry, University Hospital, Besançon, France.
Xavier PivotUniversity Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur - Ingénierie Cellulaire et Génique, Besançon, France.
Jean-Yves BlayDepartment of Medicine, Centre Léon Bérard, Lyon, France.
Samuel LimatDepartment of Pharmacy, University Hospital, Boulevard Fleming, 25030, Besançon Cedex, France.
Centre Hospitalier Universitaire de Besançon · FRUniversité Bourgogne Franche-Comté · FRCentre Georges François Leclerc · FREuropean Organisation for Research and Treatment of Cancer · BEInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe management of advanced gastrointestinal stromal tumors (GISTs) has been modified considerably by the availability of costly tyrosine kinase inhibitors (TKIs); however, the best therapeutic sequence in terms of cost and effectiveness remains unknown.

objectiveThe aim of this study was to compare four potential strategies (reflecting the potential daily practice), each including imatinib 400 mg/day, as first-line treatment: S1 (imatinib

methodsA Markov model was developed with a hypothetical cohort of patients and a lifetime horizon. Transition probabilities were estimated from the results of clinical trials. The analysis was performed from the French payer perspective, and only direct medical costs were included. Clinical and economic parameters were discounted, and the robustness of results was assessed.

resultsThe least costly and effective strategy was S1, at a cost of €65,744 for 32.9 life months (reference). S3 was the most cost-effective strategy, with an incremental cost-effectiveness ratio (ICER) of €48,277/life-year saved (LYS). S2 was dominated, and S4 yielded an ICER of €363,320/LYS compared with S3. Sensitivity analyses confirmed the robustness of these results; however, when taking into account a price reduction of 80 % for imatinib, S2 and S4 become the most cost-effective strategies.

conclusionOur approach is innovative to the extent that our analysis takes into account the sequential application of TKIs. The results suggest that the S1 strategy is the best cost-effective strategy, but a price reduction of imatinib impacts on the results. This approach must continue, including new drugs and their impact on the quality of life of patients with advanced GISTs.

Indexed as

Cost-Benefit AnalysisCost of IllnessDrug CostsFemaleGastrointestinal NeoplasmsGastrointestinal Stromal TumorsHumansImatinib MesylateIndolesMarkov ChainsProtein Kinase InhibitorsProtein-Tyrosine KinasesPyrrolesQuality of LifeSunitinibImatinib MesylateIndolesProtein Kinase InhibitorsProtein-Tyrosine KinasesPyrrolesSunitinib

Identifiers

PMID27665470
OpenAlexW2521631523

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.