An Italian cost-effectiveness analysis of paclitaxel albumin (nab®-paclitaxel) + gemcitabine vs gemcibatine alone for metastatic pancreatic cancer patients: The APICE study

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). Result(s): 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. Conclusion(s): Nab-P + G in MPC patients can be considered cost-effective for the INHS.Copyright © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.