Cost-effectiveness analysis of gemcitabine, S-1 and gemcitabine plus S-1 for treatment of advanced pancreatic cancer based on GEST study

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• 作者：Jing Zhou (1)
  Rongce Zhao (2)
  Feng Wen (1)
  Pengfei Zhang (1)
  Ruilei Tang (1)
  Zedong Du (3)
  Xiaofeng He (4)
  Jian Zhang (1)
  Qiu Li (1)
  
  1. Department of Medical Oncology ; Cancer Center ; State Key Laboratory of Biotherapy ; West China Hospital ; Sichuan University ; Chengdu ; People鈥檚 Republic of China
  2. Division of Liver Transplantation ; Department of Liver Surgery ; West China Hospital ; Sichuan University ; Chengdu ; People鈥檚 Republic of China
  3. Department of Oncology ; 363 Hospital ; Chengdu ; People鈥檚 Republic of China
  4. Department of Medical Oncology ; First People鈥檚 Hospital ; Chengdu ; People鈥檚 Republic of China
  
• 关键词：Cost ; effectiveness ; Pancreatic cancer ; Gemcitabine ; S ; 1 ; Gemcitabine plus S ; 1
• 刊名：Medical Oncology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：32
• 期：4
• 全文大小：417 KB
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• 刊物主题：Oncology; Hematology; Pathology; Internal Medicine;
• 出版者：Springer US
• ISSN：1559-131X

文摘

Gemcitabine (GEM) alone, S-1 alone and gemcitabine plus S-1 (GS) have shown a marginal clinical benefit for the treatment of advanced pancreatic cancer. However, there is no clearly defined optimal cost-effectiveness treatment. The objective of this study was to assess the cost-effectiveness of GEM alone, S-1 alone and GS for the treatment of advanced pancreatic cancer based on GEST study for public payers. A decision model compared GEM alone, S-1 alone and GS. Primary base case data were identified using the GEST study and the literatures. Costs were estimated from West China Hospital, Sichuan University, China, and incremental cost-effectiveness ratios (ICERs) were calculated. Survival benefits were reported in quality-adjusted life-months (QALMs). Sensitive analyses were performed by varying potentially modifiable parameters of the model. The base case analysis showed that the GEM cost $21,912 and yielded survival of 6.93 QALMs, S-1 cost $19,371 and yielded survival of 7.90 QALMs and GS cost $22,943 and yielded survival of 7.46 QALMs in the entire treatment. The one-way sensitivity analyses showed that the ICER of S-1 was driven mostly by the S-1 group utility score of stable state compared with GEM, and the GEM group utility score of progressed state played a key role on the ICER of GS compared with GEM. S-1 represents an attractive cost-effective treatment for advanced pancreatic cancer, given the favorable cost per QALM and improvement in clinical efficacy, especially the limited available treatment options.