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Economic evaluation for the UK of nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreas cancer.

Gharaibeh M, McBride A, Bootman JL, Abraham I - Br. J. Cancer (2015)

Bottom Line: A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis.Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA.The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.

View Article: PubMed Central - PubMed

Affiliation: Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA.

ABSTRACT

Background: The combination of nab-paclitaxel plus gemcitabine (NAB-P+GEM) has shown superior efficacy over GEM monotherapy in metastatic pancreas cancer (MPC). Independent cost-effectiveness/utility analyses of NAB-P+GEM from the payer perspective have not been conducted for the UK.

Methods: A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis. Total cost included the cost of supportive care medications, administration, chemotherapy, disease monitoring, and adverse reactions; and was discounted at 3.5% per year. A full lifetime horizon and third party payer perspective was chosen.

Results: The total cost of NAB-P+GEM was £5466 higher than the cost for GEM. Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA.

Conclusions: The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.

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Related in: MedlinePlus

Structure of the survival model for advanced MPC.
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fig1: Structure of the survival model for advanced MPC.

Mentions: A literature-based state-transition Markov model was developed in which patients in each treatment arm are described by a set of disease status reflecting the treatment pathway and outcomes (see Figure 1 for the structure of the survival model). Patients start in the model at the initiation of chemotherapy. After the first cycle of chemotherapy, there are three possible next states, each with associated probabilities: staying in the same MPC disease stage until the next cycle (PFS); progressing to the next MPC disease stage; or death. Patients in the progressive disease state have two possible next states: further disease progression or death. This is repeated across all cycles until the end of the chemotherapy regimen or death.


Economic evaluation for the UK of nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreas cancer.

Gharaibeh M, McBride A, Bootman JL, Abraham I - Br. J. Cancer (2015)

Structure of the survival model for advanced MPC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4402455&req=5

fig1: Structure of the survival model for advanced MPC.
Mentions: A literature-based state-transition Markov model was developed in which patients in each treatment arm are described by a set of disease status reflecting the treatment pathway and outcomes (see Figure 1 for the structure of the survival model). Patients start in the model at the initiation of chemotherapy. After the first cycle of chemotherapy, there are three possible next states, each with associated probabilities: staying in the same MPC disease stage until the next cycle (PFS); progressing to the next MPC disease stage; or death. Patients in the progressive disease state have two possible next states: further disease progression or death. This is repeated across all cycles until the end of the chemotherapy regimen or death.

Bottom Line: A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis.Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA.The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.

View Article: PubMed Central - PubMed

Affiliation: Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA.

ABSTRACT

Background: The combination of nab-paclitaxel plus gemcitabine (NAB-P+GEM) has shown superior efficacy over GEM monotherapy in metastatic pancreas cancer (MPC). Independent cost-effectiveness/utility analyses of NAB-P+GEM from the payer perspective have not been conducted for the UK.

Methods: A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis. Total cost included the cost of supportive care medications, administration, chemotherapy, disease monitoring, and adverse reactions; and was discounted at 3.5% per year. A full lifetime horizon and third party payer perspective was chosen.

Results: The total cost of NAB-P+GEM was £5466 higher than the cost for GEM. Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA.

Conclusions: The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.

Show MeSH
Related in: MedlinePlus