Cost-effectiveness analysis of nab-paclitaxel plus gemcitabine versus folfirinox in the treatment of metastatic pancreatic cancer in china

ABSTRACT

Objectives

Nab-paclitaxel (Abraxane®) plus gemcitabine (AG) and Fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX) have shown significant clinical benefit and been widely used as 1^st-line treatment of metastatic pancreatic cancer (mPC) in China. This study aims to compare the cost-effectiveness of AG versus FOLFIRINOX regimen for the treatment of mPC patients in China.

Methods

Markov model was developed with a lifetime survival projection in Microsoft Excel® to simulate the progression of the mPC over time. The quality-adjusted life years (QALYs), resource consumption in the health care sector and incremental cost-effectiveness ratios (ICERs) were reported. Uncertainty was assessed by one-way and probabilistic sensitivity analyses.

Results

AG regimen provided an effectiveness of 1.35 QALY at an average cost of USD 22,300 whereas FOLFIRINOX regimen brought 0.82 QALY at a cost of USD 22,980 in lifetime horizon. Therefore, AG regimen was dominant with an ICER of USD −1300 compared with FOLFIRINOX regimen. AG arm generated less drug cost, medical cost, hospitalization cost, and end-of-life cost than FOLFIRINOX arm did. Sensitivity analyses confirmed the robustness of base case findings.

Conclusions

AG is likely a cost-effective option for the 1^st-line mPC treatment compared with FOLFIRINOX in China from the perspective of healthcare system.

KEYWORDS:

• Nab-paclitaxel
• FOLFIRINOX
• cost-effectiveness analysis
• metastatic pancreatic cancer
• china

Acknowledgments

The authors also wants to thank Ms. Yanjun Liu and Mr. Chong Ye for their dedicated support of the study.

Author contribution statement

All of the authors have contributed significantly to the collection and analysis of data, have reviewed and edited the manuscript, and have agreed to its content and submission for publication. The authors were fully responsible for all content and editorial decisions.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This study was funded by BeiGene China.