Table 1 Cheers guidelines

1

Identify the study as an economic evaluation, or use more specific terms such as “cost-effectiveness analysis” and describe the interventions compared.

Value based pricing of Sorafenib compared to best supportive care.

2

Provide a structured summary of objectives, perspective, setting, methods (including study design and inputs), results (including base-case and uncertainty analyses), and conclusions.

Objectives, perspective, setting, methods (including study design and inputs), results including base-case and uncertainty analyses), and conclusions are included in the manuscript.

3

Provide an explicit statement of the broader context for the study. Present the study question and its relevance for health policy or practice decisions.

Definition of value based price for sorafenib. Definition of a price that reflects added value and utility of sorafenib treatment.

4

Describe characteristics of the base-case population and subgroups analyzed including why they were chosen.

Patients presented with metastatic RCC (as per indication)

5

State relevant aspects of the system (s) in which the decision (s) need (s) to be made.

Cyprus Public Health Care Sector

6

Describe the perspective of the study and relate this to the costs being evaluated.

Costs from Payer’s perspective in Cyprus

7

Describe the interventions or strategies being compared and state why they were chosen.

BSC vs sorafenib, a new VEGR agent product for this indication Bsc was chosed based on current local practice. Sorafenib was chosen since it belongs in the group of medicines with significant budget impact and high annual sales increase.

8

State the time horizon (s) over which costs and consequences are being evaluated and say why appropriate.

Time horizon is 10 years, by the end of this period all patients will transit into 3 stage (death).

9

Report the choice of discount rate (s) used for costs and outcomes and say why appropriate.

3.5% as per literature

10

Describe what outcomes were used as the measure (s) of benefit in the evaluation and their relevance for the type of analysis performed.

QALY due to its universal acceptance

11

Single study–based estimates: Describe fully the design features of the single effectiveness study and why the single study was a sufficient source of clinical effectiveness data.

A high quality low bias clinical trial [13]. In the Methodology section

12

Synthesis-based estimates: Describe fully the methods used for the identification of included studies and synthesis of clinical effectiveness data.

N/A

13

Model-based economic evaluation: Describe approaches and data sources used to estimate resource use associated with model health states. Describe primary or secondary research methods for valuing each resource item in terms of its unit cost. Describe any adjustments made to approximate to opportunity costs.

In the Methodology section

14

Report the dates of the estimated resource quantities and unit costs. Describe methods for adjusting estimated unit costs to the year of reported costs if necessary. Describe methods for converting costs into a common currency base and the exchange rate.

In the Methodology section

15

Describe and give reasons for the specific type of decision-analytical model used. Providing a figure to show model structure is strongly recommended.

In the Methodology section. Figure 1

16

Describe all structural or other assumptions underpinning the decision-analytical model.

In the Methodology section

17

Describe all analytical methods supporting the evaluation.

In the Methodology Section

18

Report the values, ranges, references, and, if used, probability distributions for all parameters. Report reasons or sources for distributions used to represent uncertainty where appropriate. Providing a table to show the input values is strongly recommended.

Tables 2, 3 and 4

19

For each intervention, report mean values for the main categories of estimated costs and outcomes of interest, as well as mean differences between the comparator groups. If applicable, report incremental cost-effectiveness ratios.

In Results section. Table 5

20

Model-based economic evaluation: Describe the effects on the results of uncertainty for all input parameters, and uncertainty related to the structure of the model and assumptions.

Sensitivity analysis was performed. Table 6

21

Summarise key study findings and describe how they support the conclusions reached. Discuss limitations and the generalisability of the findings and how the findings fit with current knowledge

In Results section