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• W2563863358 abstract "6114 Background: Metastatic pancreatic cancer (MPC) is an aggressive disease with a median survival of 6 months when treated with gemcitabine (G). Gemcitabine + capecitabine (G+C), gemcitabine + erlotinib (G+E), and FOLFIRINOX (FFX) are emerging as new treatment options. However, these new treatment options are costly and it is unclear which is the most cost-effective. Methods: A Markov model was constructed for a hypothetical cohort of patients with MPC to examine the costs and outcomes of 4 treatment options (G, G+C, G+E, FFX) over a time horizon of 2 years. Primary outcome was the incremental cost-effectiveness ratio measured in dollars per quality adjusted life-year ($/QALY). The analysis was conducted from the perspective of the Canadian public healthcare system. Efficacy data of the treatments were obtained from phase III clinical trial literature. Resource utilization data were derived from reviewing charts of consecutive patients (n=42) treated at Princess Margaret Hospital from 2008 to 2009 and supplemented with resource utilization data from the literature. Unit costs were obtained from the Ontario Ministry of Health and Long-Term Care, Sunnybrook Health Sciences Centre and the literature. Utilities were obtained by surveying academic medical oncologists (n=25) across Canada using EQ-5D. Costs were calculated in 2010 Canadian dollars (CAD$). Both cost and effectiveness were discounted at 3%. Results: See table below for costs and outcomes. The incremental cost-effectiveness ratios of G+C, G+E and FFX when compared to G were $82,982/QALY, $204,952/QALY and $154,323/QALY, respectively. The model is mostly driven by the acquisition cost of drugs, and may be sensitive to the relative efficacy of treatments. FFX may be cost-effective at a willingness-to-pay (WTP) threshold of $100,000/QALY if the acquisition costs of the chemotherapy drugs are reduced by 40%. Conclusions: G+C is cost-effective when compared to G if WTP is at $100,000/QALY. Price negotiation between the payer and manufacturer may be important to allow for clinically effective treatment options to be funded cost-effectively. G G+C G+E FFX Cost (CAD$) 29,658 34,139 46,874 65,924 Life expectancy (years) 0.677 0.762 0.790 1.005 QALY 0.529 0.583 0.613 0.764" @default.
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• W2563863358 date "2011-05-20" @default.
• W2563863358 modified "2023-10-16" @default.
• W2563863358 title "Cost-effectiveness of systemic therapies for metastatic pancreatic cancer." @default.
• W2563863358 doi "https://doi.org/10.1200/jco.2011.29.15_suppl.6114" @default.
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