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Economic Evaluation for the UK of Systemic Chemotherapies as First-Line Treatment of Metastatic Pancreatic Cancer

Author

Listed:
  • Mahdi Gharaibeh

    (University of Arizona)

  • Ali McBride

    (University of Arizona Cancer Center
    Banner University Medical Center-Tucson
    University of Arizona)

  • David S. Alberts

    (University of Arizona Cancer Center)

  • Brian Erstad

    (University of Arizona
    University of Arizona)

  • Marion Slack

    (University of Arizona
    University of Arizona)

  • Nimer Alsaid

    (University of Arizona
    University of Arizona)

  • J. Lyle Bootman

    (University of Arizona
    University of Arizona)

  • Ivo Abraham

    (University of Arizona
    University of Arizona Cancer Center
    University of Arizona
    University of Arizona)

Abstract

Background Gemcitabine (GEM), oxaliplatin plus GEM (OX + GEM), cisplatin plus GEM (CIS + GEM), capecitabine plus GEM (CAP + GEM), FOLFIRINOX (FFX), and nab-paclitaxel plus GEM (NAB-P + GEM) are the most commonly used regimens as first-line treatment of metastatic pancreatic cancer (MPC) in the UK. Independent economic evaluation of these regimens simultaneously has not been conducted for the UK. Objective Using data from a network meta-analysis as efficacy measures, we estimated the cost effectiveness and cost utility of these regimens for the UK. Methods A three-state Markov model (progression-free, progressed-disease, and death) simulating the total costs and health outcomes (quality-adjusted life-years [QALYs] gained and life-years [LYs]) was developed to estimate the incremental cost-utility (ICUR) and incremental cost-effectiveness ratios (ICER) for patients with MPC, from the payer perspective. The model was specified to calculate total costs in 2017 British pounds (GBP, £). All values were discounted at 3.5% per year over a full lifetime horizon. One-way sensitivity and probabilistic sensitivity analyses were conducted to assess the impact of parameter uncertainty on the results. Results FFX was the most effective regimen, NAB-P + GEM was the most costly regimen, and GEM was the least costly and least effective regimen. OX + GEM, CIS + GEM, and NAB-P + GEM were dominated by CAP + GEM and FFX. Compared with GEM, the ICUR for CAP + GEM and FFX was £28,066 and £33,020/QALY gained, respectively; compared with GEM, the ICER for CAP + GEM and FFX was £17,437 and £22,291/LY gained, respectively; and compared with CAP + GEM, the ICUR and ICER for FFX were £34,947/QALY gained and 24,414/LY gained, respectively. Conclusions At a threshold value of £30,000/QALY, CAP + GEM was found to be the only cost-effective regimen in the management of MPC in the UK.

Suggested Citation

  • Mahdi Gharaibeh & Ali McBride & David S. Alberts & Brian Erstad & Marion Slack & Nimer Alsaid & J. Lyle Bootman & Ivo Abraham, 2018. "Economic Evaluation for the UK of Systemic Chemotherapies as First-Line Treatment of Metastatic Pancreatic Cancer," PharmacoEconomics, Springer, vol. 36(11), pages 1333-1343, November.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:11:d:10.1007_s40273-018-0684-8
    DOI: 10.1007/s40273-018-0684-8
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    1. Angela Stainthorpe & Janette Greenhalgh & Adrian Bagust & Marty Richardson & Angela Boland & Sophie Beale & Rui Duarte & Eleanor Kotas & Lindsay Banks & Daniel Palmer, 2018. "Paclitaxel as Albumin-Bound Nanoparticles with Gemcitabine for Untreated Metastatic Pancreatic Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 36(10), pages 1153-1163, October.
    2. Unknown, 2014. "Department Publications 2013," Publications Lists 206935, University of Minnesota, Department of Applied Economics.
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