Literature DB >> 27041733

Prophylactic pasireotide administration following pancreatic resection reduces cost while improving outcomes.

Daniel E Abbott1, Jeffrey M Sutton1, Peter L Jernigan1, Alex Chang1, Patrick Frye1, Shimul A Shah1, Daniel P Schauer2, Mark H Eckman2, Syed A Ahmad1, Jeffrey J Sussman1.   

Abstract

BACKGROUND AND OBJECTIVES: Pasireotide decreases leak rates after pancreatic resection, though significant drug cost may be prohibitive. We conducted a cost-effectiveness analysis to determine whether prophylactic pasireotide possesses a reasonable cost profile.
METHODS: A cost-effectiveness model compared pasireotide administration after pancreatic resection versus usual care, populated by probabilities of clinical outcomes from a randomized trial and hospital costs (2013 US$) from a university pancreatic disease center. Sensitivity analyses were performed to identify influential clinical components of the model.
RESULTS: With the cost of pasireotide included, per patient costs of pancreatectomy, including those for readmission, were lower in the intervention arm (41,769 versus 42,159$; net savings of 390$, or 1%). This was associated with a 56% reduction in pancreatic fistula/pancreatic leak/abscess (PF/PL/A; 21.9-9.2%). Pasireotide cost would need to increase by over 15.4% to make the intervention strategy more costly than usual care. Sensitivity analyses exploring variability of key model inputs demonstrated that the three strongest drivers of cost were (i) cost of pasireotide; (ii) probability of readmission; and (iii) probability of PF/PL/A.
CONCLUSIONS: Prophylactic pasireotide administration following pancreatectomy is cost savings, reducing expensive post-operative sequealae (major complications and readmissions). Pasireotide should be utilized as a cost-saving measure in pancreatic resection. J. Surg. Oncol. 2016;113:784-788.
© 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Entities:  

Keywords:  cost-effectiveness; pancreatectomy; pancreatic fistula; pancreatic leak; pasireotide

Mesh:

Substances:

Year:  2016        PMID: 27041733     DOI: 10.1002/jso.24239

Source DB:  PubMed          Journal:  J Surg Oncol        ISSN: 0022-4790            Impact factor:   3.454


  5 in total

Review 1.  Cost-effectiveness comparison of prophylactic octreotide and pasireotide for prevention of fistula after pancreatic surgery.

Authors:  Thilo Welsch; Benjamin Müssle; Marius Distler; Holger Knoth; Jürgen Weitz; Dennis Häckl
Journal:  Langenbecks Arch Surg       Date:  2016-05-28       Impact factor: 3.445

2.  Risk-stratified analysis of pasireotide for patients undergoing pancreatectomy.

Authors:  June S Peng; Daniel Joyce; Maureen Brady; Adrienne Groman; Kristopher Attwood; Boris Kuvshinoff; Steven N Hochwald; Moshim Kukar
Journal:  J Surg Oncol       Date:  2020-05-30       Impact factor: 3.454

Review 3.  [Evidence-based supportive measures to secure pancreatic anastomoses].

Authors:  O Belyaev; W Uhl
Journal:  Chirurg       Date:  2017-01       Impact factor: 0.955

4.  Selective Perioperative Administration of Pasireotide is More Cost-Effective Than Routine Administration for Pancreatic Fistula Prophylaxis.

Authors:  Jason W Denbo; Rebecca S Slack; Morgan Bruno; Jordan M Cloyd; Laura Prakash; Jason B Fleming; Michael P Kim; Thomas A Aloia; Jean-Nicolas Vauthey; Jeffrey E Lee; Matthew H G Katz
Journal:  J Gastrointest Surg       Date:  2017-01-03       Impact factor: 3.452

5.  Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation.

Authors:  Alexandra W Acher; James R Barrett; Patrick B Schwartz; Chris Stahl; Taylor Aiken; Sean Ronnekleiv-Kelly; Rebecca M Minter; Glen Leverson; Sharon Weber; Daniel E Abbott
Journal:  J Gastrointest Surg       Date:  2020-07-15       Impact factor: 3.452

  5 in total

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