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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

Cost-effectiveness acceptability curves.
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fig3: Cost-effectiveness acceptability curves.

Mentions: The expected costs and outcomes of NAB-P+GEM and GEM in the UK are presented in Table 2. In the base case analysis, NAB-P+GEM treatment was more expensive than GEM treatment (£9314 vs £3848) but yielded incremental benefits in terms of LYG (0.97 vs 0.79) and QALYs (0.52 vs 0.45). The ICER was £30 367/LYG while the ICUR was £78 086/QALY. The PSA confirmed the base case results: NAB-P+GEM was more expensive (£9320 vs £3839) but yielded incremental benefits in terms of LYG (0.99 vs 0.80) and QALYs (0.54 vs 0.47) of the same order of magnitude. The PSA-generated ICER and ICUR were £28 847/LYG and £78 300/QALY, respectively. All of the 2000 simulations in the PSA confirmed the additional costs and incremental benefits for NAB-P+GEM over GEM (Figure 2) indicating that there is no probability of NAB-P+GEM having a poorer outcome than GEM. The Cost Effectiveness Acceptability Curves assess the uncertainty surrounding the mean ICER. The probability that NAB-P+GEM would be considered cost-effective compared with GEM alone was 50% for a threshold value of £78 000/QALY and 70% for a threshold value of £97 000/QALY (Figure 3).


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)

Cost-effectiveness acceptability curves.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Cost-effectiveness acceptability curves.
Mentions: The expected costs and outcomes of NAB-P+GEM and GEM in the UK are presented in Table 2. In the base case analysis, NAB-P+GEM treatment was more expensive than GEM treatment (£9314 vs £3848) but yielded incremental benefits in terms of LYG (0.97 vs 0.79) and QALYs (0.52 vs 0.45). The ICER was £30 367/LYG while the ICUR was £78 086/QALY. The PSA confirmed the base case results: NAB-P+GEM was more expensive (£9320 vs £3839) but yielded incremental benefits in terms of LYG (0.99 vs 0.80) and QALYs (0.54 vs 0.47) of the same order of magnitude. The PSA-generated ICER and ICUR were £28 847/LYG and £78 300/QALY, respectively. All of the 2000 simulations in the PSA confirmed the additional costs and incremental benefits for NAB-P+GEM over GEM (Figure 2) indicating that there is no probability of NAB-P+GEM having a poorer outcome than GEM. The Cost Effectiveness Acceptability Curves assess the uncertainty surrounding the mean ICER. The probability that NAB-P+GEM would be considered cost-effective compared with GEM alone was 50% for a threshold value of £78 000/QALY and 70% for a threshold value of £97 000/QALY (Figure 3).

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