Economic evaluation for the UK of nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreas cancer

The combination of nab-paclitaxel plus gemcitabine (NAB-P+GEM) has shown superior efficacy over GEM monotherapy in metastatic pancreas cancer (MPC). Independent cost-effectiveness/utility analyses of NAB-P+GEM from the payer perspective have not been conducted for the UK. A Markov model simulating t...

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Bibliographic Details
Published in:British journal of cancer 2015-04, Vol.112 (8), p.1301-1305
Main Authors: Gharaibeh, M, McBride, A, Bootman, J L, Abraham, I
Format: Article
Language:English
Subjects:
Adult
Albumins - administration & dosage
Albumins - economics
Antimetabolites, Antineoplastic - administration & dosage
Antimetabolites, Antineoplastic - economics
Antineoplastic Combined Chemotherapy Protocols - economics
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Clinical Study
Cost-Benefit Analysis
Deoxycytidine - administration & dosage
Deoxycytidine - analogs & derivatives
Deoxycytidine - economics
Humans
Markov Chains
Middle Aged
Models, Economic
Neoplasm Metastasis
Paclitaxel - administration & dosage
Paclitaxel - economics
Pancreatic Neoplasms - drug therapy
Pancreatic Neoplasms - economics
Quality-Adjusted Life Years
Survival Analysis
United Kingdom
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Summary:The combination of nab-paclitaxel plus gemcitabine (NAB-P+GEM) has shown superior efficacy over GEM monotherapy in metastatic pancreas cancer (MPC). Independent cost-effectiveness/utility analyses of NAB-P+GEM from the payer perspective have not been conducted for the UK. A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis. Total cost included the cost of supportive care medications, administration, chemotherapy, disease monitoring, and adverse reactions; and was discounted at 3.5% per year. A full lifetime horizon and third party payer perspective was chosen. The total cost of NAB-P+GEM was £5466 higher than the cost for GEM. Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA. The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.2015.65