Kidney cancer can be defined as cancer that forms in the tissues of the kidneys. It includes renal cell carcinoma, renal pelvis carcinoma, and Wilms tumor that affects children under the age of 5 years. According to the U.S. national institute of health, estimated new cases and deaths from kidney cancer in the United States in the year 2009 were 49,096 and 11,033, respectively.
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The U.S. national cancer institute keeps a cancer database and provides useful information to cancer patients and their families regarding treatment options available and the management of physical and emotional effects of cancer. Recent studies have shown Sunitinib to be preferred standard care for kidney cancer. Sunitinib is a small-molecule oral cancer drug that has been found to increase the life of kidney patients by 4-6 months and was approved by the U.S. Food and Drug Administration in January 2006 (Hartmann 2008, 67).
The annual cost of using Sunitinib as a treatment drug for kidney cancer is $54,000. It is necessary to carry out a cost-benefit analysis before approving the use of this drug for treatment. The incremental cost-effectiveness ratio for the use of Sunitinib as a treatment option is the ratio of the change in the cost for administering this treatment compared to other treatment alternatives to the change in effects of the treatment. The incremental cost-effectiveness ratio is thus used to rank different treatment options available and formulating a priority list.
Preference is given to those treatment options with the least cost-effectiveness ratio during budget allocation so as to maximize the net health benefits from the fixed budget. In case the cost for the use of Sunitinib far much outweigh the change in treatment effects, thereby resulting in a high cost-effectiveness ratio, then the use of Sunitinib should never be prescribed. Treatment options having high cost-effectiveness ratios lead to wastage of resources as no economic benefits will be realized in investing in such options.
Another factor to consider is whether or not to approve prescription of Sunitinib for the treatment of kidney cancer is uncertainty. Analysis of the various forms of uncertainty in health care economic evaluation is paramount as wrong decisions may lead to loss of opportunities and taxpayer resources. Sensitivity analysis can be used to check whether the estimated costs and effects would significantly change if other reasonable values were to be used. Uncertainty helps create a rank list were opportunities with more certainty being preferred. If two or more treatment options for kidney cancer are considered with the use of Sunitinib being one of them, then if they use Sunitinib has a more certainty rank than the other options, its use as a treatment drug for kidney cancer should be prescribed.
Although Sunitinib may economically be proven fit for the treatment of kidney cancer, it has demerits to its use as a cancer treatment drug. The cost of the use of Sunitinib is relatively high. Criticism of this fact has been forthcoming as the drug does not treat cancer, and many patients can’t afford the cost of treatment. In the U.S., many insurance companies have refused to pay for the treatment of cancer using this drug, forcing many cancer patients to dig deep into their pockets to meet hospital bills for their treatment. Sunitinib therapy also has health side effects. It causes hypertension, fatigue, stomatitis, and diarrhea to its users (Socinski 2006, 91). According to the placebo-controlled phase III GIST study, Sunitinib causes anorexia, skin discoloration, asthenia, altered taste, and constipation.
Hartmann J.T. & Kanz ,L. (2008). Sunitinib and periodic hair depigmentation due to temporary c-KIT inhibition. Cambridge: Cambridge university press.
Socinski M.A. (2006).Efficacy and safety of Sunitinib in previously treated, advanced non-small cell lung cancer (NSCLC): preliminary results of a multicenter phase II trial. Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings Part I 24.