Economic evaluation of NALIRIFOX vs. nab-paclitaxel and gemcitabine regimens for first-line treatment of metastatic pancreatic ductal adenocarcinoma from U.S. perspective

Shao, Hanqiao; Fang, Hongshu; Li, Yuan; Jiang, Yunlin; Zhao, Mingye; Tang, Wenxi

doi:10.1186/s12962-024-00578-5

Cost Effectiveness and Resource Allocation

Table 1 Model input parameters

From: Economic evaluation of NALIRIFOX vs. nab-paclitaxel and gemcitabine regimens for first-line treatment of metastatic pancreatic ductal adenocarcinoma from U.S. perspective

Name	Baseline value	Low	Upper	Distribution	Source
Cost ($)
Leucovorin calcium injection (50 mg)	4.46	3.57	5.35	gamma	[17]
Fluorouracil injection (500 mg)	2.84	2.27	3.41	gamma	[17]
Oxaliplatin (0.5 mg)	0.07	0.06	0.08	gamma	[17]
Inj irinotecan liposome (1 mg)	62.49	49.99	74.98	gamma	[17]
Paclitaxel protein bound (1 mg)	14.79	11.83	17.74	gamma	[17]
In gemcitabine hcl nos (200 mg)	3.93	3.15	4.72	gamma	[17]
Capecitabine oral (500 mg)	1.17	0.94	1.40	gamma	[17]
Carboplatin injection (50 mg)	2.76	2.21	3.31	gamma	[17]
Irinotecan injection (20 mg)	2.06	1.65	2.48	gamma	[17]
Magnetic Resonance Imaging	308.35	95.47	539.54	gamma	[17]
Chemo iv infusion for 1 h	134.90	113.09	181.29	gamma	[17]
Sequential infusion each additional hour	28.25	25.43	31.08	gamma	[17]
Premedication cost for nab-paclitaxel and gemcitabine	152.92	122.34	183.50	gamma	[15]
Premedication cost for NALIRIFOX	1236.13	988.90	1483.36	gamma	[15]
follow up cost before progression	519.04	415.23	622.85	gamma	[15]
follow up cost after progression	1064.65	851.72	1277.58	gamma	[15]
Best supportive care/cycle	2137.11	1709.69	2564.53	gamma	[23]
End-of-life/patient	21747.14	17397.71	26096.57	gamma	[24]
Clinical input
Weibull model for NALIRIFOX PFS (shape)	1.22	1.10	1.34	gamma	Model fitting results
Weibull model for NALIRIFOX PFS (scale)	10.47	9.45	11.61	gamma	Model fitting results
Utility
PFS	0.74	0.73	0.76	beta	[13]
PD	0.67	0.65	0.69	beta	[5]
Disutility of adverse events
Diarrhoea	0.21	0.17	0.25	beta	[15]
Nausea	0.05	0.04	0.06	beta	[25]
Vomiting	0.05	0.04	0.06	beta	[5]
Decreased appetite	0.0020	0.0018	0.0024	beta	[26]
Fatigue	0.2040	0.1836	0.2244	beta	[27]
Asthenia	0.2040	0.1836	0.2244	beta	[13]
Neutropenia	0.0900	0.0620	0.1220	beta	[25]
Anaemia	0.2040	0.1836	0.2244	beta	[13]
Peripheral neuropathy	0.2260	0.2034	0.2486	beta	[28]
Abdominal pain	0.0510	0.0200	0.1000	beta	[29]
Mucosal inflammation	0.2690	0.2421	0.2959	beta	[30]
Constipation	0.1700	0.1530	0.1870	beta	[31]
Ascites	0.1700	0.1530	0.1870	beta	[31]
Increased γ-glutamyltransferase	0.1700	0.1530	0.1870	beta	[31]
Time duration of adverse events (days)
Diarrhoea	5.57	5.013	6.127	normal	[5]
Nausea	11.18	10.0611	12.2969	normal
Vomiting	5.85	5.2668	6.4372	normal
Decreased appetite	22.04	19.8378	24.2462	normal
Fatigue	19.89	17.8965	21.8735	normal
Asthenia	17.63	15.8661	19.3919	normal
Neutropenia	9.547	8.5923	10.5017	normal
Anaemia	12.40	11.16	13.64	normal
Peripheral neuropathy	26.917	24.2253	29.6087	normal
Abdominal pain	10.452	9.4068	11.4972	normal
Cost for adverse events treatment per cycle
Diarrhea	7332.19	5865.75	8798.63	gamma	[15]
Nausea	7660.29	6128.23	9192.35	gamma	[32]
Vomiting	830.60	664.48	996.72	gamma	[32]
Neutropenia	13656.00	10924.80	16387.20	gamma	[33]
Anemia	7941.00	6352.80	9529.20	gamma	[33]
Asthenia	8099.62	6479.70	9719.54	gamma	[34]
Peripheral Neuropathy	30734.00	24587.20	36880.80	gamma	[35]
Decreased appetite	160.00	128.00	192.00	gamma	[36]
Increased γ-glutamyltransferase	5584.70	4467.76	6701.64	gamma	[31]
Abdominal pain	6538.09	5230.47	7845.71	gamma	[30]
Ascites	10191.85	8153.48	12230.22	gamma	[31]
Constipation	6749.29	5399.43	8099.15	gamma	[31]
Mucosal inflammation	10797.87	8638.30	12957.44	gamma	[30]
Fatigue	2668.76	2135.01	3202.51	gamma	[31]
Risk of adverse events in NALIRIFOX
Diarrhoea	0.20	0.18	0.22	beta	[7]
Nausea	0.12	0.108	0.132	beta
Vomiting	0.07	0.063	0.077	beta
Decreasaed appetite	0.09	0.081	0.099	beta
Fatigue	0.06	0.054	0.066	beta
Asthenia	0.09	0.081	0.099	beta
Neutropenia	0.14	0.126	0.154	beta
Anaemia	0.11	0.099	0.121	beta
Abdominal pain	0.04	0.036	0.044	beta
Peripheral neuropathy	0.03	0.027	0.033	beta
Ascites	0.03	0.027	0.033	beta
Constipation	0.02	0.018	0.022	beta
Mucosal inflammation	0.02	0.018	0.022	beta
Increased γ-glutamyltransferase	0.06	0.054	0.066	beta
Risk of adverse events in nab-paclitaxel and gemcitabine
Diarrhoea	0.05	0.045	0.055	beta	[7]
Nausea	0.03	0.027	0.033	beta
Vomiting	0.02	0.018	0.022	beta
Decreasaed appetite	0.03	0.027	0.033	beta
Fatigue	0.05	0.045	0.055	beta
Asthenia	0.05	0.045	0.055	beta
Neutropenia	0.25	0.225	0.275	beta
Anaemia	0.17	0.153	0.187	beta
Peripheral neuropathy	0.06	0.054	0.066	beta
Increased γ-glutamyltransferase	0.06	0.054	0.066	beta
Other
Body Surface Area (m²)	1.79	1.78	1.80	normal	[13]
discount	0.03	0	0.08	beta	[13]
Proportions of subsequent treatment
NALIRIFOX	0.505	-	-	-	[7]
nab-paclitaxel and gemcitabine	0.544	-	-	-	[7]

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