Cost-utility analysis of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in combination with gemcitabine in metastatic pancreatic cancer in Spain: results of the PANCOSTABRAX study

Abstract

The PANCOSTABRAX study evaluated the cost–effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in combination with gemcitabine (GEM) versus GEM alone in the treatment of patients with metastatic pancreatic cancer in Spain. Efficacy data were obtained from the MPACT study and were modeled to a lifetime horizon using a Markov model. The analysis was performed from the payer’s perspective. Use of resources and key assumptions of the analysis were validated by a panel of oncologists. The addition of nab-paclitaxel to GEM showed higher effectiveness results (0.156 additional quality adjusted life years) at a higher cost (€6,477), resulting in a cost per quality-adjusted life years gained of €41,519. The combination of nab-paclitaxel and GEM has been shown to be an effective and well-tolerated option for the treatment of metastatic pancreatic cancer and, in addition to becoming the new standard of care, could also be considered a cost-effective option.

Keywords:

• cancer
• cost
• nab-paclitaxel
• pancreatic
• Spain

Financial & competing interests disclosure

This study was funded by Celgene (Madrid, Spain). Celgene employees were involved in the study design, the editing and review of the manuscript, and the decision to submit the manuscript for publication. This study was conducted by Oblikue Consulting (Barcelona, Spain), an independent consulting company, and received funds from Celgene. The expert members of the PANCOSTABRAX working group received consulting fees from Celgene and have also acted as consultant/advisors for other pharmaceutical companies. 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.

Key issues

• Nab-paclitaxel is a nanoparticle albumin-bound paclitaxel, without solvent, for injectable suspensions indicated for the first-line treatment of MPA in combination with GEM. Its favorable efficacy and toxicity profile helps to focus treatment on the tumor.

• The PANCOSTABRAX study is the first economic evaluation of nab-paclitaxel in combination with GEM as first-line treatment of MPA in Spain.

• The results of the PANCOSTABRAX study in Spain showed that nab-paclitaxel in combination with GEM is an effective and well-tolerated alternative that could also be considered cost-effective compared with GEM alone.