| Title |
Economic Evaluation for USA of Systemic Chemotherapies as First-Line Treatment of Metastatic Pancreatic Cancer
|
|---|---|
| Published in |
PharmacoEconomics, June 2018
|
| DOI | 10.1007/s40273-018-0678-6 |
| Pubmed ID | |
| Authors |
Mahdi Gharaibeh, Ali McBride, David S. Alberts, Marion Slack, Brian Erstad, Nimer Alsaid, J. Lyle Bootman, Ivo Abraham |
| Abstract |
Treatments for metastatic pancreatic cancer include monotherapy with gemcitabine (GEM); combinations of GEM with oxaliplatin (OX + GEM), cisplatin (CIS + GEM), capecitabine (CAP + GEM), or nab-paclitaxel (NAB-P + GEM); and the non-GEM combination FOLFIRINOX. Combination therapies have yielded better survival outcomes than GEM alone. A sponsor-independent economic evaluation of these regimens has not been conducted for USA. The objective of this study was to estimate the cost utility and cost effectiveness of these regimens from the payer perspective for USA. A three-state Markov model (progression-free, progressed disease, death) simulating the total costs and health outcomes (quality-adjusted life-years; life-years) was developed to estimate the incremental cost-utility and cost-effectiveness ratios. FOLFIRINOX clinical data were obtained from trial and indirect estimates were obtained from network meta-analyses. Lifetime horizon and 3%/year discount rates were used. FOLFIRINOX was the most expensive regimen and GEM the least costly regimen. Compared to GEM, all but one (CIS + GEM) regimen were found to be more effective in quality-adjusted life-years and life-years. Compared to GEM, the incremental cost-utility ratios for CAP + GEM, OX-GEM, NAB-P + GEM, and FOLFIRINOX, were US$180,503, US$197,993, US$204,833, and US$265,718 per additional quality-adjusted life-year, respectively; and the incremental cost-effectiveness ratios were US$88,181, US$87,620, US$135,683, and US$167,040 per additional life-year, respectively. A probabilistic sensitivity analysis confirmed the base-case analysis. This sponsor-independent economic evaluation for USA found that OX + GEM, CAP + GEM, FOLFIRINOX, and NAB-P + GEM, but not CIS + GEM, were more expensive but also more effective than GEM alone in terms of quality-adjusted life-years and life-years gained. The NAB-P + GEM regimen appears to be the most cost effective in USA at a willingness-to-pay threshold of US$200,000/quality-adjusted life-year. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 29% |
| Canada | 1 | 14% |
| Mexico | 1 | 14% |
| Unknown | 3 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 71% |
| Scientists | 2 | 29% |
Mendeley readers
The data shown below were compiled from readership statistics for 26 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 26 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 4 | 15% |
| Researcher | 4 | 15% |
| Lecturer | 3 | 12% |
| Student > Ph. D. Student | 2 | 8% |
| Student > Master | 1 | 4% |
| Other | 3 | 12% |
| Unknown | 9 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 27% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 12% |
| Nursing and Health Professions | 3 | 12% |
| Economics, Econometrics and Finance | 1 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 11 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 July 2018.
All research outputs
#7,931,166
of 25,775,807 outputs
Outputs from PharmacoEconomics
#886
of 2,001 outputs
Outputs of similar age
#125,415
of 343,278 outputs
Outputs of similar age from PharmacoEconomics
#15
of 37 outputs
Altmetric has tracked 25,775,807 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 2,001 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one has gotten more attention than average, scoring higher than 55% of its peers.
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We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.