Cost-Effectiveness Analysis Of Nab-Paclitaxel Plus Gemcitabine Versus Folfirinox In The Treatment Of Metastatic Pancreatic Cancer In China

Objectives Nab-paclitaxel (Abraxane (R)) plus gemcitabine (AG) and Fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX) have shown significant clinical benefit and been widely used as 1(st)-line treatment of metastatic pancreatic cancer (mPC) in China. This study aims to compare the cost-effectiveness of AG versus FOLFIRINOX regimen for the treatment of mPC patients in China. Methods Markov model was developed with a lifetime survival projection in Microsoft Excel (R) to simulate the progression of the mPC over time. The quality-adjusted life years (QALYs), resource consumption in the health care sector and incremental cost-effectiveness ratios (ICERs) were reported. Uncertainty was assessed by one-way and probabilistic sensitivity analyses. Results AG regimen provided an effectiveness of 1.35 QALY at an average cost of USD 22,300 whereas FOLFIRINOX regimen brought 0.82 QALY at a cost of USD 22,980 in lifetime horizon. Therefore, AG regimen was dominant with an ICER of USD -1300 compared with FOLFIRINOX regimen. AG arm generated less drug cost, medical cost, hospitalization cost, and end-of-life cost than FOLFIRINOX arm did. Sensitivity analyses confirmed the robustness of base case findings. Conclusions AG is likely a cost-effective option for the 1(st)-line mPC treatment compared with FOLFIRINOX in China from the perspective of healthcare system.