Cost-Effectiveness Analysis of Olaparib Maintenance Treatment for Germline BRCA-Mutated Metastatic Pancreatic Cancer

Li, Na; Zheng, Huanrui; Huang, Yanlei; Zheng, Bin; Cai, Hongfu; Liu, Maobai

doi:10.3389/fphar.2021.632818

Cited by 12 publications

(21 citation statements)

References 16 publications

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“…Overall, 19 studies were published after June, 2019, including 9 in 2020 [ 22 – 30 ], 7 in 2021 [ 31 – 37 ], and 3 2022 [ 38 – 40 ]. Studies were conducted from the United States (US) (n = 13) [ 16 – 20 , 23 – 28 , 38 , 40 ], China (n = 5) [ 27 , 30 , 32 , 39 , 40 ], Singapore (n = 2) [ 31 , 34 ], Japan [ 21 ], Italy [ 22 ], and Spain [ 33 ]. PARPi evaluated in these studies included olaparib [ 16 – 18 , 20 – 22 , 25 – 28 , 30 – 32 , 34 – 40 ], niraparib [ 18 – 20 , 23 , 26 , 28 ], rucaparib [ 20 , 28 ], talazoparib [ 33 ], and veliparib [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies were conducted from the United States (US) (n = 13) [ 16 – 20 , 23 – 28 , 38 , 40 ], China (n = 5) [ 27 , 30 , 32 , 39 , 40 ], Singapore (n = 2) [ 31 , 34 ], Japan [ 21 ], Italy [ 22 ], and Spain [ 33 ]. PARPi evaluated in these studies included olaparib [ 16 – 18 , 20 – 22 , 25 – 28 , 30 – 32 , 34 – 40 ], niraparib [ 18 – 20 , 23 , 26 , 28 ], rucaparib [ 20 , 28 ], talazoparib [ 33 ], and veliparib [ 24 ]. Modeling methods employed included the Markov model (n = 11) [ 16 , 21 , 22 , 24 , 28 , 30 , 32 , 36 , 37 , 39 , 40 ], decision tree model (n = 6) [ 17 – 20 , 23 , 35 ], partitional survival model (n = 7) [ 25 , …”

Section: Resultsmentioning

confidence: 99%

“…PARPi evaluated in these studies included olaparib [ 16 – 18 , 20 – 22 , 25 – 28 , 30 – 32 , 34 – 40 ], niraparib [ 18 – 20 , 23 , 26 , 28 ], rucaparib [ 20 , 28 ], talazoparib [ 33 ], and veliparib [ 24 ]. Modeling methods employed included the Markov model (n = 11) [ 16 , 21 , 22 , 24 , 28 , 30 , 32 , 36 , 37 , 39 , 40 ], decision tree model (n = 6) [ 17 – 20 , 23 , 35 ], partitional survival model (n = 7) [ 25 , 27 , 31 , 33 , 34 , 38 ], and the non-Markov alternatives (n = 1) [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies were assessed from the perspective of health care system (n = 10) [ 18 , 22 , 26 , 31 – 33 , 35 , 38 – 40 ], third-party payers (n = 10) [ 17 , 20 , 21 , 23 – 25 , 27 , 28 , 34 , 36 ] and the whole society (n = 3) [ 16 , 19 , 30 ]. Most studies reported a 3% discount rate on the cost and effects, and two studies reported a discount rate of 5% [ 32 , 40 ] and one reported 2% [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Ding

He²,

Tong³

et al. 2022

PLoS ONE

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Objectives Poly (ADP-ribose) polymerase inhibitor (PARPi) have become a mainstay for the treatment of BRCA-mutant malignancies. PARPis are likely to be more effective but also bring an increase in costs. Thus, we aimed at evaluating the cost effectiveness of PARPis in the treatment of malignancies. Methods Studies of cost effectiveness of PARPis were searched from PubMed, Web of Science, and Cochrane Library. Key information was extracted from the identified studies and reviewed. Quality of the included studies was evaluated using Quality of Health Economic Studies (QHES) instrument. Modeling techniques, measurement of parameters and uncertainty analysis were analyzed across studies. Interventions and cost-effectiveness results were reported stratified by patient population. Results Among the 25 studies identified, we included 17 on ovarian cancer, 2 on breast cancer, 3 on pancreatic cancer, and 3 on prostate cancer that involved olaparib, niraparib, rucaparib, and talazoparib. All studies had a QHES score of above 75. In the maintenance therapy of ovarian cancer, additional administration of olaparib was cost-effective for newly diagnosed patients after first-line platinum-based chemotherapy but was not cost-effective for platinum-sensitive recurrent patients in majority studies. However, the economic value of other PARPis in ovarian cancer as well as all PARPis in other tumors remained controversial. Cost-effectiveness of PARPi was primarily impacted by the costs of PARPi, survival time, health utility and discount rate. Moreover, genetic testing improved the cost-effectiveness of PARPi treatment. Conclusions PARPi is potentially cost-effective for patients with ovarian, pancreatic, or prostate cancer. Genetic testing can improve the cost-effectiveness of PARPi.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Ding

He²,

Tong³

et al. 2022

PLoS ONE

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“…Quality-adjusted life-year (QALY) was identified as the primary health outcome. It is often referred to as utility (the health-state utility ranges from 0 [death] to 1 [complete health]) (Li et al, 2021). Since BTC is a relatively rare cancer, no independent health status utility values have been published in this area.…”

Section: Effectiveness Parameters and Utility Estimatesmentioning

confidence: 99%

Cost-Effectiveness Analysis of Capecitabine Plus Oxaliplatin Versus Gemcitabine Plus Oxaliplatin as First-Line Therapy for Advanced Biliary Tract Cancers

et al. 2022

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Background: In the first-line treatment of biliary tract cancers (BTCs), XELOX (capecitabine plus oxaliplatin) showed comparable clinical efficacy and safety to gemcitabine and oxaliplatin (GEMOX), with fewer visits and better treatment management. Our study aims to investigate the cost-effectiveness of XELOX and GEMOX as the first-line therapy for BTCs from the perspective of the Chinese healthcare systems and to provide valuable suggestions for clinical decision-making.Methods: A Markov model was developed using the phase 3 randomized clinical trial (ClinicalTrials.gov number, NCT01470443) to evaluate the cost-effectiveness of XELOX and GEMOX. Quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were used as the primary outcomes of the model. Uncertainty was assessed using univariate and probabilistic sensitivity analysis.Results: The QALYs for the XELOX and GEMOX groups were 0.66 and 0.54, respectively. In China, the total cost of XELOX treatment is US $12,275.51, which is lower than that of the GEMOX regimen. In addition, XELOX is more effective than GEMOX, making it the preferred regimen. A sensitivity analysis determined that XELOX therapy has a stable economic advantage in China.Conclusion: Compared to GEMOX, XELOX is a more cost-effective treatment as a first-line treatment for advanced BTC from the perspective of the Chinese health service system.

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Olaparib for germline BRCA-mutated metastatic pancreatic cancer: cost effective in China and US

2021

PharmacoEcon Outcomes News

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Olaparib maintenance treatment is a cost-effective option in China and the US for patients with germline BRCAmutated metastatic pancreatic cancer, report researchers from China.The researchers used a three-state Markov model to evaluate the cost effectiveness of olaparib, compared with placebo, as maintenance treatment for advanced recurrent BRCA-mutated metastatic pancreatic cancer, initiated 4-8 weeks after the final dose of first-line chemotherapy. Transition probabilities for the three health states in the model were based on overall-survival and progression-free survival data from the POLO trial. The analyses were performed from the perspective of the healthcare systems in China and the US.Compared with placebo, olaparib was associated with an additional 8.77 quality-adjusted life-years (QALYs) at incremental costs of $US58 704 and $US116 881 (year 2020 values) in China and the US, respectively, over a 5-year time horizon. The incremental cost-effectiveness ratios (ICERs) were $US6694 and $US13 327 per QALY gained in China and the US, respectively. These ICERs are far below commonly accepted willingness-to-pay thresholds (¥212 676 or $US30 892 [3 × GDP per capita in China in 2019] and $US50 000 per QALY gained for China and the US, respectively). For China, the ICER was even less than 1 × GDP per capita (¥70 892 [$US10 276] in 2019), note the researchers. Sensitivity analyses showed that the cost of olaparib was the main driver of the ICERs for both countries. Health utility values of the progression-free health state also had a substantial impact on the ICERs.

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Cost-Effectiveness Analysis of Olaparib Maintenance Treatment for Germline BRCA-Mutated Metastatic Pancreatic Cancer

Cited by 12 publications

References 16 publications

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Cost-effectiveness of PARP inhibitors in malignancies: A systematic review

Cost-Effectiveness Analysis of Capecitabine Plus Oxaliplatin Versus Gemcitabine Plus Oxaliplatin as First-Line Therapy for Advanced Biliary Tract Cancers

Olaparib for germline BRCA-mutated metastatic pancreatic cancer: cost effective in China and US

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