Comparison of treatment patterns and economic outcomes among metastatic pancreatic cancer patients initiated on nab-paclitaxel plus gemcitabine versus FOLFIRINOX

ABSTRACT

Background: The economic burden of metastatic pancreatic cancer (mPC) is substantial while treatment options are limited. Little is known about the treatment patterns and healthcare costs among mPC patients who initiated first-line gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-P + G) and FOLFIRINOX.

Methods: The MarketScan® claims databases were used to identify adults with ≥2 claims for pancreatic cancer, 1 claim for a secondary malignancy, completed ≥1 cycle of nab-P + G or FOLFIRINOX during 4/1/2013 and 3/31/2015, and had continuous plan enrollment for ≥6 months pre- and 3 months after the first-line treatment. Duration of therapy, per patient per month (PPPM) costs of total healthcare, mPC-related treatment, and supportive care were measured during first-line therapy.

Results: 550 mPC patients met selection criteria (nab-P + G, n = 294; FOLFIRINOX, n = 256). There was no difference in duration of therapy (p = 0.60) between nab-P + G and FOLFIRINOX. Compared with FOLFIRINOX, patients with nab-P + G had higher chemotherapy drug costs but lower treatment administration costs and supportive care costs (all p < 0.01).

Conclusions: Patients treated with nab-P + G (vs FOLFIRINOX) had similar treatment duration but lower costs of outpatient prescriptions, treatment administration and supportive care. Lower supportive care costs in the nab-P + G cohort were mainly driven by lower utilization of pegfilgrastim and anti-emetics.

KEYWORDS:

• Economic burden
• FOLFIRINOX
• gemcitabine plus nanoparticle albumin-bound paclitaxel
• metastatic pancreatic cancer
• real-world data
• treatment patterns

Previous publications

Some of the results are presented at 2017 Gastrointestinal Cancers Symposium. San Francisco, CA, January 19-21, 2017; and 2017 Hematology/Oncology Pharmacy Association 13th Annual Conference. Anaheim, CA, March 29-1 April 2017.

Declaration of interest

M Bonafede, Q Cai, N Princic, and O Tran are employees of Truven Health Analytics, an IBM company. Truven Health Analytics received compensation from Celgene Corporation for the overall conduct of the study and preparation of this manuscript. C Pelletier, M Parisi, and M Patel are employees of Celgene Corporation. A McBride was an employee of the University of Arizona Cancer Center. 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.

Additional information

Funding

The current study was sponsored by Celgene Corporation.