Carlo Lazzaro1, Carlo Barone2, Francesco Caprioni3, Stefano Cascinu4, Alfredo Falcone5, Evaristo Maiello6, Michele Milella7, Carmine Pinto8, Michele Reni9, Giampaolo Tortora10. 1. a Studio di Economia Sanitaria , Milan , Italy. 2. b Policlinico Gemelli , Rome , Italy. 3. c Ospedale S. Martino , Genoa , Italy. 4. d Policlinico di Modena , Modena , Italy. 5. e Azienda Ospedaliera Universitaria Pisana , Pisa , Italy. 6. f Casa Sollievo della Sofferenza , S. Giovanni Rotondo , Italy. 7. g Istituto Nazionale Tumori Regina Elena , Rome , Italy. 8. h Ospedale S. Maria Nuova , Reggio Emilia , Italy. 9. i Ospedale S. Raffaele , Milan , Italy. 10. j Azienda Ospedaliera Universitaria Integrata Borgo Roma , Verona , Italy.
Abstract
BACKGROUND: the APICE study evaluates the cost-effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel - Nab-P) + gemcitabine (G) vs G alone in metastatic pancreatic cancer (MPC) from the Italian National Health Service (INHS) standpoint. RESEARCH DESIGN AND METHODS: A 4-year, 4 health states (progression-free; progressed; end of life; death) Markov model based on the MPACT trial was developed to estimate costs (Euro [€], 2017 values), and quality-adjusted life years (QALYs). Patients were assumed to receive intravenously Nab-P 125 mg/m2 + G 1000 mg/m2 on days 1, 8, and 15 every 4 weeks or G alone 1000 mg/m2 weekly for 7 out of 8 weeks (cycle 1) and then on days 1, 8, and 15 every 4 weeks (cycle 2 and subsequent cycles) until progression. One-way and probabilistic sensitivity analyses explored the uncertainty surrounding the baseline incremental cost-utility ratio (ICUR). RESULTS: Nab-P + G totals 0.154 incremental QALYs and €7082.68 incremental costs vs G alone. ICUR (€46,021.58) is lower than the informal threshold value of €87,330 adopted by the Italian Medicines Agency during 2010-2013 for reimbursing oncological drugs. Sensitivity analyses confirmed the robustness of the baseline findings. CONCLUSIONS: Nab-P + G in MPC patients can be considered cost-effective for the INHS.
BACKGROUND: the APICE study evaluates the cost-effectiveness of nanoparticle albumin-bound paclitaxel (nab-paclitaxel - Nab-P) + gemcitabine (G) vs G alone in metastatic pancreatic cancer (MPC) from the Italian National Health Service (INHS) standpoint. RESEARCH DESIGN AND METHODS: A 4-year, 4 health states (progression-free; progressed; end of life; death) Markov model based on the MPACT trial was developed to estimate costs (Euro [€], 2017 values), and quality-adjusted life years (QALYs). Patients were assumed to receive intravenously Nab-P 125 mg/m2 + G 1000 mg/m2 on days 1, 8, and 15 every 4 weeks or G alone 1000 mg/m2 weekly for 7 out of 8 weeks (cycle 1) and then on days 1, 8, and 15 every 4 weeks (cycle 2 and subsequent cycles) until progression. One-way and probabilistic sensitivity analyses explored the uncertainty surrounding the baseline incremental cost-utility ratio (ICUR). RESULTS:Nab-P + G totals 0.154 incremental QALYs and €7082.68 incremental costs vs G alone. ICUR (€46,021.58) is lower than the informal threshold value of €87,330 adopted by the Italian Medicines Agency during 2010-2013 for reimbursing oncological drugs. Sensitivity analyses confirmed the robustness of the baseline findings. CONCLUSIONS:Nab-P + G in MPC patients can be considered cost-effective for the INHS.
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