Abstract P1-10-05: A cost utility analysis from a Chinese health care perspective of Nab-paclitaxel or docetaxel, both as alternatives to solvent-based paclitaxel in metastatic breast cancer (MBC)

Abstract

Abstract Background: Paclitaxel and docetaxel are commonly used for the treatment of MBC in China. However, one important drawback, particularly with docetaxel, is the potential for dose-limiting toxicity. To improve the side effect profile and efficacy of paclitaxel, an albumin-bound formulation (nab-paclitaxel) is currently available in China (Abraxane®). To provide health economic data for China, a cost utility analysis comparing nab-paclitaxel to docetaxel, both as alternatives to paclitaxel was conducted. Methods: Clinical data was obtained from a meta analysis of randomized trials comparing either nab-paclitaxel (260 mg/m2 q3wk) or branded docetaxel (100 mg/m2 q3wk) to solvent-based branded paclitaxel (175 mg/m2 q3wk). Health care resource use for the delivery of chemotherapy and the management of grade 3/4 toxicity was collected from a time and motion study in three Chinese cancer centers, from a survey of clinicians and from the oncology literature. Using the Time Trade-off technique, treatment preferences and utility estimates were obtained from interviewing 28 cancer patients from two centres in China. All costs were reported in 2014 $U.S. Results: Nab-paclitaxel had the most favourable safety profile characterized with the lowest incidence of grade 3/4 neutropenia, febrile neutropenia, anemia, emesis and stomatitis. This translated to lower costs for managing the grade 3/4 side effects of nab-paclitaxel relative to both docetaxel and paclitaxel ($21 vs. $166 vs. $81) In the preference assessment, 22 of 28 (78.6%) patients selected nab-paclitaxel as their preferred agent. As an alternative to paclitaxel, the incremental cost per quality adjusted life year (QALY) gained was determined to be more favourable with nab-paclitaxel than docetaxel ($57,900 vs. $130,600). Conclusions: Nab-paclitaxel is an economically attractive alternative to both paclitaxel and docetaxel in MBC patients, providing a substantially lower cost per QALY. Additionally in the patient preference survey, the majority of patients surveyed selected nab-paclitaxel as their preferred agent. Citation Format: George Dranitsaris, Bo Yu, Jennifer King, Adams Zhang, Satyn Kaura, Zhai Qing. A cost utility analysis from a Chinese health care perspective of Nab-paclitaxel or docetaxel, both as alternatives to solvent-based paclitaxel in metastatic breast cancer (MBC) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-10-05.