TY - JOUR
T1 - An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel) + gemcitabine vs gemcitabine alone for metastatic pancreatic cancer patients
T2 - the APICE study
AU - Lazzaro, Carlo
AU - Barone, Carlo
AU - Caprioni, Francesco
AU - Cascinu, Stefano
AU - Falcone, Alfredo
AU - Maiello, Evaristo
AU - Milella, Michele
AU - Pinto, Carmine
AU - Reni, Michele
AU - Tortora, Giampaolo
PY - 2018/4/21
Y1 - 2018/4/21
N2 - 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.
AB - 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.
KW - Cost-effectiveness analysis
KW - gemcitabine
KW - Italy
KW - metastatic pancreatic cancer
KW - nab-paclitaxel
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U2 - 10.1080/14737167.2018.1464394
DO - 10.1080/14737167.2018.1464394
M3 - Article
AN - SCOPUS:85045734416
SP - 1
EP - 12
JO - Expert Review of Pharmacoeconomics and Outcomes Research
JF - Expert Review of Pharmacoeconomics and Outcomes Research
SN - 1473-7167
ER -