PCN100 ECONOMIC EVALUATION OF FOLFIRINOX VERSUS GEMCITABINE IN THE TREATMENT OF METASTATIC PANCREATIC CANCER IN JAPAN

Abstract

The purpose of this analysis was to evaluate the cost-effectiveness of FOLFIRINOX in patients with metastatic pancreatic cancer, comparing with gemcitabine. Partitioned survival model was developed to predict costs and quality-adjusted life years (QALYs) in FOLFIRINOX and gemcitabine arms. Direct medical costs were considered from the perspective of the Japanese healthcare system. Time horizon and cycle length of the model was set to 5 years and 1 month, respectively. An annual discount rate of 2% for both costs and QALYs was applied. Data on overall survival and progression-free survival was derived from the published randomized controlled trial. Cost parameters were estimated by using the JMDC claims database. All costs were estimated in Japanese yen and converted to US dollars with the currency exchange rate of $ 1 = JPY100. Utilities were derived from published sources other than Japan. The incremental cost-effectiveness ratio (ICER) of FOLFIRINOX compared with gemcitabine was estimated. Deterministic sensitivity analysis was performed to assess uncertainty in parameter settings. Compared with gemcitabine, FOLFIRINOX incurred an additional cost of $ 28,518 and conferred an additional 0.247 QALY. This resulted in the ICER of $ 115,421 per QALY gained. Costs for post-progression had a relatively large impact on the base case result, but the ICERs remained higher than $ 50,000 per QALY over the full range of model parameters. Applying the willingness to pay threshold of $ 50,000 per QALY, FOLFIRINOX might not be cost-effective. Further research is required on utilities of Japanese patients with pancreatic cancer.