Abstract
BackgroundA randomized clinical trial has found that the addition of erlotinib to gemcitabine (GEM-E) for pancreatic cancer led to a modest increase in survival. The aim of this national population-based retrospective study was to compare the effectiveness of GEM-E to GEM alone for pancreatic cancer patients in real clinical practice.MethodsPatients with pancreatic cancer (ICD-10: C25) with prescription claims of gemcitabine or erlotinib between Jan 1, 2007 and Dec 31, 2012 were retrospectively identified from the Korean Health Insurance claims database. To be included in the study population, patients were required to have had a histological or cytological diagnosis within one year before chemotherapy. Patients treated with prior radiotherapy, surgery, or chemotherapy were excluded to reduce heterogeneity. Overall survival from the initiation of therapy and the medical costs of GEM-E and GEM were compared.ResultsA total of 4,267 patients were included in the analysis. Overall survival was not significantly longer in patients treated with GEM-E (median 6.77 months for GEM-E vs. 6.68 months for GEM, p = 0.0977). There was also no significant difference in the respective one-year survival rates (27.0 % vs. 27.3 %; p = 0.5988). Multivariate analysis using age, gender, and comorbidities as covariates did not reveal any significant differences in survival. Based on this relative effectiveness, the incremental cost per life year gained over GEM was estimated at USD 70,843.64 for GEM-E.ConclusionsGEM-E for pancreatic cancer is not more effective than GEM in a real-world setting, and it does not provide reasonable cost-effectiveness over GEM.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2482-z) contains supplementary material, which is available to authorized users.
Highlights
A randomized clinical trial has found that the addition of erlotinib to gemcitabine (GEM-E) for pancreatic cancer led to a modest increase in survival
With the National Health Insurance Service (NHIS) database, it is possible to monitor from a payer perspective the impact of adopting new drugs on resource utilization and the effectiveness of new treatments used in routine clinical practice
This retrospective study aimed to evaluate the effectiveness and cost effectiveness of GEM-E compared to GEM for pancreatic cancer patients, using data from the South Korean NHIS claims database
Summary
Selection of patients with pancreatic cancer This was a population-based, retrospective analysis using the NHIS database to identify patients with pancreatic cancer who began chemotherapy with GEM-E or GEM between January 1, 2007 and December 31, 2012. The study population included patients who received GEM therapy by injection for pancreatic cancer (ICD10: C25). We excluded patients who had a diagnosis of hepatobiliary cancer (C24), bronchial and lung cancer (C34), breast cancer (C50), ovarian cancer (C56), and bladder cancer (C67), each within 5 years before and after the index date; those who were diagnosed with pancreatic neuroendocrine cancer (C25.4) after cohort entry; those who received GEM as a therapy for other cancers; and those who were younger than 18 years. Medical cost per patient for GEM-E and GEM was measured using claims data during the entire follow-up period. OS was calculated from the date of initiation of GEM-E or GEM to the date of last follow-up or death from any cause, using the Kaplan-Meier method and log-rank test.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
