An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel) + gemcitabine vs gemcitabine alone for metastatic pancreatic cancer patients: the APICE study

Carlo Lazzaro, C Barone, Francesco Caprioni, S Cascinu, A Falcone, E Maiello, M Milella, C Pinto, M Reni, G Tortora

Research output: Contribution to journalArticle

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/m 2  + G 1000 mg/m 2 on days 1, 8, and 15 every 4 weeks or G alone 1000 mg/m 2 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. © 2018 Informa UK Limited, trading as Taylor & Francis Group
Original languageEnglish
Pages (from-to)435-446
Number of pages12
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Volume18
Issue number4
DOIs
Publication statusPublished - 2018

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