Pharmacoeconomic Evaluation of Erlotinib for the Treatment of Pancreatic Cancer

Abstract

PurposeTo evaluate the cost-effectiveness of gemcitabine and gemcitabine plus erlotinib as first-line treatments for advanced pancreatic cancer. MethodsOn the basis of the Gemcitabine With/Out Erlotinib in Unresectable Locally Advanced/Metastatic Pancreatic Cancer (PA.3) trial, the Markov model was constructed to simulate the development of advanced pancreatic cancer. Cost-effectiveness analysis was used to determine the economic level of the treatments, according to the willingness-to-pay (WTP) threshold. The sensitivity analysis was conducted for cost-effectiveness and other indexes. FindingsThe results of the cost-effectiveness analysis revealed that the cost-effectiveness ratios for the first-line treatment of advanced pancreatic cancer were ¥60,492.78 (US$8892.44/€7568.88) per 6.34 quality-adjusted life-months (QALMs) for gemcitabine and ¥99,595.39 (US$14,640.52/€12,461.42) per 7.02 QALMs for gemcitabine plus erlotinib. The incremental cost-effectiveness of the 2 regimens was ¥57,503.84 ($8453.06/€7194.90) per QALM, which was higher than the WTP set in this study (¥16,161 [$2375.66/€2022.07] per QALM). The results of the sensitivity analysis indicate that the analysis results were stable. Gemcitabine was more cost-effective than gemcitabine plus erlotinib. ImplicationsCompared with gemcitabine, gemcitabine plus erlotinib was not cost-effective at the level of the WTP. Gemcitabine plus erlotinib therapy has no economic significance as a first-line medical treatment for pancreatic cancer.