Comparison of treatment patterns, resource utilization, and cost of care in patients with metastatic pancreatic cancer treated with first-line nab-paclitaxel plus gemcitabine or FOLFIRINOX
Comparison of treatment patterns, resource utilization, and cost of care in patients with metastatic pancreatic cancer treated with first-line nab-paclitaxel plus gemcitabine or FOLFIRINOX
复制标题
DOI：
10.1080/17512433.2017.1302330
复制
发表时间：
2017-05-01
影响因子：
4.4
通讯作者：
Belk, Kathy W.
中科院分区：
文献类型：
--
作者：
Kim, George P.;Parisi, Monika F.;Belk, Kathy W.
背景资料：我们比较了一线nab-紫杉醇+吉西他滨或FOLFIRINOX（5-氟尿嘧啶，甲酰四氢叶酸，伊立替康，奥沙利铂）治疗转移性胰腺癌患者的实际治疗模式，资源利用和护理成本。主要终点包括中位治疗中止时间（TTD）和每例患者每月的总护理费用。次要终点包括支持性治疗费用和住院率和longs.Results：总体而言，345例患者包括（白蛋白结合型紫杉醇+吉西他滨，n = 182; FOLFIRINOX，n = 163）。白蛋白结合型紫杉醇+吉西他滨组的中位TTD显著长于FOLFIRINOX组（4.3 vs 2.8个月; P = .0009）。白蛋白结合型紫杉醇+吉西他滨的平均采购成本较高（10，643美元vs 6549美元; P = .0043），但平均总护理成本较低（16，628美元vs 19，936美元; P = .1740）。白蛋白结合型紫杉醇+吉西他滨组的支持性治疗费用显著较低（1995美元vs 6456美元; P < .0001）。住院率和长度都显着降低与白蛋白结合型紫杉醇+ gemcitabine.Conclusions：尽管较高的收购成本与白蛋白结合型紫杉醇+吉西他滨，FOLFIRINOX治疗的患者有较高的总成本驱动的支持性治疗。在评估护理总成本时，应考虑毒性相关成本和药物采购成本。
Background: We compared real-world treatment patterns, resource utilization, and cost of care for patients with metastatic pancreatic cancer treated with first-line nab-paclitaxel + gemcitabine or FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, oxaliplatin).Methods: This was a retrospective study of inpatient and hospital-based outpatient data in the United States. Primary endpoints included median time to treatment discontinuation (TTD) and total cost of care per patient per month. Secondary endpoints included supportive care costs and hospitalization rate and length.Results: Overall, 345 patients were included (nab-paclitaxel + gemcitabine, n = 182; FOLFIRINOX, n = 163). Median TTD was significantly longer with nab-paclitaxel + gemcitabine vs FOLFIRINOX (4.3 vs 2.8 months; P = .0009). Mean acquisition cost was higher with nab-paclitaxel + gemcitabine ($10,643 vs $6549; P = .0043), but mean total cost of care was lower ($16,628 vs $19,936; P = .1740). Supportive care cost was significantly lower with nab-paclitaxel + gemcitabine ($1995 vs $6456; P < .0001). Hospitalization rate and length were both significantly lower with nab-paclitaxel + gemcitabine.Conclusions: Despite higher acquisition costs with nab-paclitaxel + gemcitabine, FOLFIRINOX-treated patients had higher total costs driven by supportive care. Toxicity-related costs and drug acquisition costs should be considered when evaluating total cost of care.