PCN8: ECONOMIC EVALUATION OF GEMZAR IN THE TREATMENT OF PANCREATIC CANCER IN THE UK

Abstract

OBJECTIVES: Pancreatic cancer is a significant and increasing cause of morbidity and mortality in the UK. Treatment with chemotherapy has shown to improve symptoms and survival of patients. Gemzar is licenced for treatment of pancreatic cancer in the UK. This study reports on an economic evaluation of Gemzar relative to 5-FU, a commonly used regimen for advanced pancreatic cancer patients in the UK. METHODS: The perspective is that of the UK-NHS. Data were derived from a clinical trial (Burris et al in 1998). Total treatment costs estimates are based on chemotherapy, infusions, hospitalisations, visits to health care professionals and concomitant medications. Resource utilisation data, derived from the trial, were combined with unit cost data from various UK sources. The time horizon is 18 months and costs relate to 2000. A 6% discounting rate was applied. Effectiveness was measured by: survival, progression-free survival, and % of clinical benefit responders Extensive sensitivity analysis was performed to test the robustness of the results. RESULTS: Total treatment cost per patient on Gemzar was estimated at £3,569 and on 5-FU at £1,262?the difference attributed mainly to higher drug acquisition costs. Gemzar was associated with an incremental gain of 0.188 life years, 0.116 progression-free-life-years and 19% of patients could be classifed as clinical benefit responders. As such, relative to 5-FU, the incremental cost-per-clinical-benefit-responder with Gemzar is £12,172, the incremental cost-per-life-year-gained is £12,206 and the incremental cost-per-progression-free-life-year gained is £19,888. Sensitivity analyses showed that the results did not vary significantly with changes of the parameters. When 5-FU is administered by continuous infusion, the cost per patient increases to £1,900 and the incremental cost-effectiveness of Gemzar is improved. CONCLUSIONS: This economic evaluation demonstrates that Gemzar consists a cost-effective alternative to an existing therapy that is commonly used in the UK for treatment of pancreatic cancer. The incremental cost-effectiveness of Gemzar compares favourably with that of other treatments funded by the NHS.