5% ac cording to current All Technologies Around MDV3100 practice in Uk and Sweden. Willingness to pay threshold is not officially defined in Cyprus. Thus, we adopted recommenda tions of WHO pertaining to utilisation of multiplies of Gross Domestic Item per capita as being a proxy for WTP threshold. In 2012 the estimated GDP per capita recent costs was twenty,517 euro, consequently we define the WTP threshold at 60,000 euro. Due to the fact sorafenib is an orphan drug, we utilized the highest recommended level. We carried out one way sensitivity analysis in an effort to identify which variables and also to which extent influence end result. Value distribution of general medical and also other pharma ceutical charges was as sumed to comply with gamma distribution because ordinarily fees are non commonly distributed, very skewed and demon strate kurtosis.
Method of moments was utilized so that you can estimate parameters of this distribution. Sorafenib expenditures had been denoted by a uniform distribution as per the suggested every day dosage because we assume that all patients acquire recommended each day dose. We adopted the well being state utilities as reported by Thomson which have been assessed via the use of Uk EQ 5D well being state utilities of 0. 76 for PFS and 0. 68 for PD. Considering that utility value are defined involving 0 and one, we assume that they stick to a beta distribution as following Markov Model was loaded with an preliminary cohort of 1,000 individuals. Sufferers had been supposed to become on the sec ond line of treatment method with sorafenib with an indication of metastasis. We discarded the very first 50,000 iterations of simulation to guarantee stability of the model and we per formed an additional 50,000 iterations to guarantee convergence and accuracy of data.
We checked convergence through trace plots of samples and standard error on the final results. Other healthcare and pharmaceutical expenses Cancer individuals in Cyprus, with yearly cash flow much less than 150,000 euro are entitled to no cost public health care care. Utilization of pharmaceutical and health care cost was assessed based on National pointers and availability of solutions listed in the national formulary. Costs of pharmaceuticals have been extracted from the national formulary when medical costs have been cal culated primarily based on 2012 database. Benefits Remedy with sorafenib benefits to incremental get 0,1605 QALY per patient, compared to BSC. This would result in 16996 euro price per sorafenib patient in contrast to 7336 euro per patient on very best support ive care.
Our Worth primarily based pricing strategy indicates that underneath a 60,000 theoretical WTP threshold, cost of sorafenib should be set at 1816 euro per bundle, a value notably reduced in contrast to existing price tag. Underneath current value the Incremental Expense Effectiveness Ratio is 102,879 as well as the well being gains expense 16470 euro additional per patient. Sensitivity analysis We carried out 1 way sensitivity evaluation. ICER was proved to become considerable delicate for the price tag of sorafenib, even though health care together with other pharmaceutical had a minimum effect on ICER.