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

Carlo Lazzaro, Carlo Barone, Francesco Caprioni, Stefano Cascinu, Alfredo Falcone, Evaristo Maiello, Michele Milella, Carmine Pinto, Michele Reni, Giampaolo Tortora

Research output: Contribution to journalArticlepeer-review

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.
Original languageItalian
Pages (from-to)1-12
Number of pages12
JournalExpert Review of Pharmacoeconomics and Outcomes Research
DOIs
Publication statusPublished - Apr 21 2018

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