Cost-effectiveness of Gemcitabine Plus Modern Radiotherapy in Locally Advanced Pancreatic Cancer

被引:12
作者
Leung, Henry W. C. [1 ,2 ]
Chan, Agnes L. F. [3 ,4 ]
Muo, Chih-Hsin [5 ]
机构
[1] China Med Univ, An Nan Hosp, Dept Radiat Therapy, Tainan, Taiwan
[2] Chia Nan Univ Pharm & Sci, Dept Informat Management, Tainan, Taiwan
[3] China Med Univ, An Nan Hosp, Dept Pharm, 66,Sec 2,Changhe Rd,709, Tainan, Taiwan
[4] Chia Nan Univ Pharm & Sci, Dept Pharm, Tainan, Taiwan
[5] China Med Univ Hosp, Management Off Hlth Data, Taichung, Taiwan
关键词
cost-effectiveness; economic evaluation; locally advanced pancreatic cancer; stereotactic body radiotherapy; BODY RADIATION-THERAPY; INTENSITY-MODULATED RADIOTHERAPY; COOPERATIVE-ONCOLOGY-GROUP; PHASE-III TRIAL; ADENOCARCINOMA; SURVIVAL; GUIDELINES;
D O I
10.1016/j.clinthera.2016.03.005
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Purpose: The purpose of this study was to evaluate the cost-effectiveness of gemcitabine plus modern radiotherapy versus gemcitabine alone in the treatment of locally advanced pancreatic cancer in Taiwan. Methods: A Markov decision-analytic model was performed to compare the cost-effectiveness of 3 treatment regimens; gemcitabine alone (gem-alone), gemcitabine plus intensity-modulated radiotherapy (gem-IMRT), and gemcitabine plus stereotactic body radiotherapy (gem-SBRT). Patients transitioned between 5 health states: stable disease, local progression, distant metastasis, local and distant metastasis, and death. Findings: The incremental cost-effectiveness ratio for gem-IMRT and gem-SBRT compared with gem alone were NT$27,120,168 and NT$2,145,683 per quality-adjusted life-year gained, respectively. A willingness to pay threshold of 3 times the per capita gross domestic product was adopted according to the definition of the World Health Organization. The Taiwan per capita gross domestic product in 2015 was NT$673,920 (US$22,464; 1 NT$ = US$0.03333 in Taiwan); thus, a threshold was considered as NT $2,021,760 (US$67,392). The Monte-Carlo simulation found that the probability of cost-effectiveness at a willingness to pay threshold of NT$2,021,760 per quality-adjusted life-year was 0% chance for gem-IMRT and 50% for gem-SBRT. Implications: This study indicated that gem-IMRT or gem-SBRT in locally advanced pancreatic cancer is not cost-effective at a willingness to pay as defined by World Health Organization guideline in Taiwan. (C) 2016 Elsevier HS Journals, Inc. All rights reserved.
引用
收藏
页码:1174 / 1183
页数:10
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