Economic evaluation of gemcitabine in the treatment of pancreatic cancer in the UK.

This study evaluated the cost-effectiveness of gemcitabine as first-line treatment for pancreatic cancer in the UK. Outcomes data and costs based on utilisation data were analysed from a previously reported clinical trial. Outcome measures were average and incremental costs of survival gain, progression-free survival gain and clinical benefit response (a symptom-based measure) for gemcitabine compared with 5-fluorouracil (5-FU) via intravenous injection in the first-line setting. The incremental costs per life-year and per progression-free life-year were pounds sterling 12,206 and pounds sterling 19,888, respectively, for gemcitabine over 5-FU therapy. The incremental cost per clinical benefit responder for gemcitabine over 5-FU was pounds sterling 12,142. If 5-FU was administered by 24-h continuous infusion rather than being given once a week, treatment costs were estimated to be more expensive. The resulting incremental cost per life-year gained with gemcitabine falls to pounds sterling 8,831. Sensitivity analyses (including alterations based on statistical variance) demonstrated that the results were robust and relatively insensitive to variations in key parameters. Gemcitabine is thus a cost-effective therapy for patients with pancreatic cancer and cost per life-year compares favourably with other technologies funded by the National Health Service in the UK.