Nab-paclitaxel plus gemcitabine <i>vs.</i> gemcitabine for metastatic pancreatic cancer in China: a health economic evaluation_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yaling ¹ ,  DING Ningxin ² , LI Wenxiong ³

1. Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, 236000, P.R.China;
2. PHARMAC, Wellington, 006012, New Zealand;
3. Beijing Chao-Yang Hospital, Beijing, 100043, P.R.China;

Corresponding?author：

DING Ningxin, Email: cynical_ding@live.cn

Keywords：

Metastatic pancreatic cancer; Nab-paclitaxel; Gemcitabine; Cost-effectiveness; Markov model; Cost-utility analysis

DOI：

10.7507/1672-2531.201901013

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives To evaluate the economic efficacy of nab-paclitaxel (NAB-P) combined with gemcitabine (GEM) versus GEM alone in the treatment of metastatic pancreatic cancer in China.Methods A Markov model simulating the costs and health outcomes was developed to estimate quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). The impact of parameter uncertainty on the model was assessed by deterministic one-way sensitivity analysis.Results NAB-P combined with GEM was shown superior efficacy compared to gemcitabine monotherapy, however with higher costs. The ICER between the two groups was 964 780.79￥/QALY.Conclusions Compared with gemcitabine monotherapy, NAB-P combined with GEM is not cost-effective. The conclusion is confirmed by deterministic one-way sensitivity analysis.

Citation： WANG Yaling, DING Ningxin, LI Wenxiong. Nab-paclitaxel plus gemcitabine vs. gemcitabine for metastatic pancreatic cancer in China: a health economic evaluation. Chinese Journal of Evidence-Based Medicine, 2019, 19(9): 1101-1105. doi: 10.7507/1672-2531.201901013 Copy

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8.	陳菊香, 周紅軒, 馬蘭, 等. 吉西他濱聯合奧沙利鉑或替吉奧對比吉西他濱單藥治療晚期胰腺癌臨床觀察. 安徽醫藥, 2015, (2): 359-362.
9.	王曉玥, 伍春燕, 宋秋, 等. 診斷相關分組醫療費用結算模式在中國的應用前景與探討. 中國基層醫藥, 2013, 20(15): 2386-2387.
10.	姚嵐. 醫療保障學. 北京: 人民衛生出版社, 2013.
11.	Tam VC, Ko YJ, Mittmann N, et al. Cost-effectiveness of systemic therapies for metastatic pancreatic cancer. Curr Oncol, 2013, 20(2): e90-e106.
12.	Goldstein D, El-Maraghi RH, Hammel P, et al. nab-Paclitaxel plus gemcitabine for metastatic pancreatic cancer: long-term survival from a phase Ⅲ trial. J Natl Cancer Inst, 2015, 107(2): 413.
13.	魏蕾, 李自雄, 秦叔逵, 等. 吉西他濱單藥或聯合白蛋白結合型紫杉醇治療東亞人群晚期胰腺癌臨床療效的薈萃分析. 臨床腫瘤學雜志, 2019, 24(2): 137-144.
14.	Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, et al. Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol, 2013, 31(1): 23-29.
15.	Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med, 2011, 364(19): 1817-1825.

1. 王付湘. 吉西他濱單藥與吉西他濱聯合化療治療晚期胰腺癌療效及安全性評價. 中外醫學研究, 2015, (14): 145-147.
2. 楊軍, 李賀, 鄭榮壽, 等. 2014 年中國胰腺癌發病與死亡分析. 中國腫瘤, 2018, 27(6): 420-425.
3. 湯少梁, 陳文靜. 基于 Markov 模型對我國晚期胰腺癌 3 種化療方案的藥物經濟學研究. 中國藥房, 2018, 29(6): 784-789.
4. Burris HA 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol, 1997, 15(6): 2403-2413.
5. von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med, 2013, 369(18): 1691-1703.
6. Gharaibeh M, McBride A, Bootman JL, et al. Economic evaluation for the UK of nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreas cancer. Br J Cancer, 2015, 112(8): 1301-1305.
7. Gharaibeh M, McBride A, Bootman JL, et al. Economic evaluation for the US of nab-paclitaxel plus gemcitabine versus FOLFIRINOX versus gemcitabine in the treatment of metastatic pancreas cancer. J Med Econ, 2017, 20(4): 345-352.
8. 陳菊香, 周紅軒, 馬蘭, 等. 吉西他濱聯合奧沙利鉑或替吉奧對比吉西他濱單藥治療晚期胰腺癌臨床觀察. 安徽醫藥, 2015, (2): 359-362.
9. 王曉玥, 伍春燕, 宋秋, 等. 診斷相關分組醫療費用結算模式在中國的應用前景與探討. 中國基層醫藥, 2013, 20(15): 2386-2387.
10. 姚嵐. 醫療保障學. 北京: 人民衛生出版社, 2013.
11. Tam VC, Ko YJ, Mittmann N, et al. Cost-effectiveness of systemic therapies for metastatic pancreatic cancer. Curr Oncol, 2013, 20(2): e90-e106.
12. Goldstein D, El-Maraghi RH, Hammel P, et al. nab-Paclitaxel plus gemcitabine for metastatic pancreatic cancer: long-term survival from a phase Ⅲ trial. J Natl Cancer Inst, 2015, 107(2): 413.
13. 魏蕾, 李自雄, 秦叔逵, 等. 吉西他濱單藥或聯合白蛋白結合型紫杉醇治療東亞人群晚期胰腺癌臨床療效的薈萃分析. 臨床腫瘤學雜志, 2019, 24(2): 137-144.
14. Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, et al. Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol, 2013, 31(1): 23-29.
15. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med, 2011, 364(19): 1817-1825.

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Nab-paclitaxel plus gemcitabine vs. gemcitabine for metastatic pancreatic cancer in China: a health economic evaluation

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