Cost-effectiveness of sorafenib for treatment of radioactive iodine (rai)-refractory locally advanced/metastatic differentiated thyroid cancer (dtc) in Turkey

WOS: 000354498503198OBJECTIVES: Sorafenib is the first product approved for treatment of RAI refractory locally advanced/metastatic DTC patients. This study was conducted in order to analyze cost-effectiveness of sorafenib for treatment of patients with RAI refractory locally advanced/metastatic DTC in Turkey. METHODS: A cohort partition model assigning patients to one of three health states according to the proportion of patients who are progression-free, progressed, or dead in each 28-days cycle was adapted to Turkish setting. The incremental cost-effectiveness ratios (ICER) were calculated per quality-adjusted life years (QALYs) and life-years (LYs) gained. Turkish payer’s perspective was taken and time-horizon was set as patient’s lifetime (maximum 30 years). Sorafenib was compared to the best supportive care (BSC) within the model since there are no agents for treatment of patients on this stage of the disease. Essential clinical inputs were derived from DECISION trial and local resource-utilization data were based on expert opinions through an expert panel. Sensitivity of the results was evaluated in terms of key inputs by deterministic oneway and probabilistic sensitivity analyses. All costs were calculated in Turkish Liras (TL) and converted to USD using TL/USD currency rate as 2.2 (mid-2014). RESULTS: Total cost of sorafenib-treated patients is 24,384 USD higher compared to BSC. Besides, sorafenib is associated with increments of 1.29 LYs and 0.80 QALYs compared to BSC. The ICER of sorafenib per LYs and QALYs gained compared to BSC were determined as 18,851 USD and 30,485 USD respectively. One-way sensitivity analysis demonstrated that results are not sensitive to the changes in model inputs and pharmacoeconomic analysis results were validated by probabilistic sensitivity analysis. CONCLUSIONS: Sorafenib is cost-effective for treatment of patients with RAI refractory locally advanced/metastatic DTC compared to BSC with an ICER value below the willingness-to-pay threshold (3-times GDP per capita ─ 32,346 USD) for Turkey

Extending the boundaries of academic entrepreneurship: Demonstrating the instrumentality of new logics for addressing social inclusion

Academic entrepreneurship (AE) has gained widespread acclaim globally for bridging the gap between academia and industry, as well as addressing the issue of socio-economic inclusion and the impact of research. In this paper, we both relate to, and extend scholarly work in the domains of AE and social inclusion by investigating the process of AE from an interplay of institutional logics perspective, with an emphasis on the diversity strands to which academic entrepreneurs belong. Drawing on extensive fieldwork of 55 academic researchers affiliated with 6 UK universities, our findings highlight the co-existence of profession, science logic and market logic, combined with the new logics that we introduce - diversity and impact logics - in capturing value through AE for addressing social inclusion. We make an empirical and theoretical contribution by demonstrating the instrumentality of these logics as enablers and constraints on the process of AE. We also advance the theory on logics and AE by demonstrating how the intersection of logics creates different kinds ofsalient points and pressures for academics and university policy makers. Closely linked to this, we make policy contributions by putting forward policy insights that are bottom-up and tailored based on a thorough understanding of the experiences and views of academic entrepreneurs