Henry W C Leung1, Agnes L F Chan2, Chih-Hsin Muo3. 1. Department of Radiation Therapy, An Nan Hospital, China Medical University, Tainan, Taiwan; Department of Information Management, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan. 2. Department of Pharmacy, An-Nan Hospital, China Medical University, Tainan, Taiwan; Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan. Electronic address: agnes.lf@gmail.com. 3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Abstract
PURPOSE: The purpose of this study was to evaluate the cost-effectiveness of gemcitabine plus modern radiotherapy versus gemcitabine alone in the treatment of locally advanced pancreatic cancer in Taiwan. METHODS: A Markov decision-analytic model was performed to compare the cost-effectiveness of 3 treatment regimens; gemcitabine alone (gem-alone), gemcitabine plus intensity-modulated radiotherapy (gem-IMRT), and gemcitabine plus stereotactic body radiotherapy (gem-SBRT). Patients transitioned between 5 health states: stable disease, local progression, distant metastasis, local and distant metastasis, and death. FINDINGS: The incremental cost-effectiveness ratio for gem-IMRT and gem-SBRT compared with gem-alone were NT$27,120,168 and NT$2,145,683 per quality-adjusted life-year gained, respectively. A willingness to pay threshold of 3 times the per capita gross domestic product was adopted according to the definition of the World Health Organization. The Taiwan per capita gross domestic product in 2015 was NT$673,920 (US$22,464; 1 NT$ = US$0.03333 in Taiwan); thus, a threshold was considered as NT$2,021,760 (US$67,392). The Monte-Carlo simulation found that the probability of cost-effectiveness at a willingness to pay threshold of NT$2,021,760 per quality-adjusted life-year was 0% chance for gem-IMRT and 50% for gem-SBRT. IMPLICATIONS: This study indicated that gem-IMRT or gem-SBRT in locally advanced pancreatic cancer is not cost-effective at a willingness to pay as defined by World Health Organization guideline in Taiwan.
PURPOSE: The purpose of this study was to evaluate the cost-effectiveness of gemcitabine plus modern radiotherapy versus gemcitabine alone in the treatment of locally advanced pancreatic cancer in Taiwan. METHODS: A Markov decision-analytic model was performed to compare the cost-effectiveness of 3 treatment regimens; gemcitabine alone (gem-alone), gemcitabine plus intensity-modulated radiotherapy (gem-IMRT), and gemcitabine plus stereotactic body radiotherapy (gem-SBRT). Patients transitioned between 5 health states: stable disease, local progression, distant metastasis, local and distant metastasis, and death. FINDINGS: The incremental cost-effectiveness ratio for gem-IMRT and gem-SBRT compared with gem-alone were NT$27,120,168 and NT$2,145,683 per quality-adjusted life-year gained, respectively. A willingness to pay threshold of 3 times the per capita gross domestic product was adopted according to the definition of the World Health Organization. The Taiwan per capita gross domestic product in 2015 was NT$673,920 (US$22,464; 1 NT$ = US$0.03333 in Taiwan); thus, a threshold was considered as NT$2,021,760 (US$67,392). The Monte-Carlo simulation found that the probability of cost-effectiveness at a willingness to pay threshold of NT$2,021,760 per quality-adjusted life-year was 0% chance for gem-IMRT and 50% for gem-SBRT. IMPLICATIONS: This study indicated that gem-IMRT or gem-SBRT in locally advanced pancreatic cancer is not cost-effective at a willingness to pay as defined by World Health Organization guideline in Taiwan.
Authors: Marcelo Cerullo; Faiz Gani; Sophia Y Chen; Joseph K Canner; Joseph M Herman; Daniel Laheru; Timothy M Pawlik Journal: Ann Surg Date: 2018-03 Impact factor: 12.969
Authors: Jin G Choi; Ryan D Nipp; Angela Tramontano; Ayman Ali; Tiannan Zhan; Pari Pandharipande; Emily C Dowling; Cristina R Ferrone; Theodore S Hong; Deborah Schrag; Carlos Fernandez-Del Castillo; David P Ryan; Chung Yin Kong; Chin Hur Journal: Oncologist Date: 2018-12-17
Authors: Myles A Ingram; Brianna N Lauren; Yoanna Pumpalova; Jiheum Park; Francesca Lim; Susan E Bates; Fay Kastrinos; Gulam A Manji; Chung Yin Kong; Chin Hur Journal: Cancer Rep (Hoboken) Date: 2022-02-05