Informing Value-Based Pricing: Cost-Effectiveness Analysis of a Hypothetical First-Line Therapy for Metastatic Pancreatic Cancer
Author(s)
Satarupa Talukdar, Msc. Economics1, Craig van Rensburg, MCom2, Anns Thomas, Msc. Health Economics1.
1PharmaQuant Insights Private Limited, Kolkata, India, 2PharmaQuant Insights Private Limited, Dublin, Ireland.
1PharmaQuant Insights Private Limited, Kolkata, India, 2PharmaQuant Insights Private Limited, Dublin, Ireland.
OBJECTIVES: Metastatic pancreatic adenocarcinoma (mPAC) is a highly aggressive malignancy with poor prognosis and limited treatment options. Current first-line therapies offer only modest survival benefits and are often associated with significant toxicity. There is a clear unmet need for more effective and better-tolerated treatments. This study evaluated the cost-effectiveness of a hypothetical first-line therapy compared with gemcitabine monotherapy, from the perspective of the UK National Health Service (NHS) and Personal Social Services (PSS).
METHODS: A partitioned survival model was developed incorporating three health states: progression-free, progressed disease, and death. Clinical data for gemcitabine were obtained from the Kaplan-Meier curves reported in the MPACT study. The efficacy of the hypothetical therapy was estimated by applying assumed hazard ratios of 0.45 for progression-free survival (PFS) and 0.5 for overall survival (OS) to the gemcitabine curves. Adverse event data for gemcitabine were also sourced from the MPACT trial. Direct medical costs were derived from NHS reference costs, the Personal Social Services Research Unit (PSSRU), and other UK-specific sources. Health state utility values were obtained from published literature. Sensitivity analyses and scenario analyses were conducted to explore the robustness of results and the impact of key model parameters.
RESULTS: Given the high disease burden of mPAC, the hypothetical therapy was assumed to qualify for a 1.7x severity weighting, consistent with recent UK health technology assessment guidance. At a willingness-to-pay threshold of £20,000 per quality-adjusted life year (QALY) gained, the hypothetical therapy may be able to justify a therapy cost of ~£2,000 per treatment cycle.
CONCLUSIONS: Applying a 1.7x severity weight appropriately reflects the high burden associated with mPAC and supports a higher valuation of health gains. This analysis suggests that a more effective first-line therapy could be considered cost-effective at a premium price.
METHODS: A partitioned survival model was developed incorporating three health states: progression-free, progressed disease, and death. Clinical data for gemcitabine were obtained from the Kaplan-Meier curves reported in the MPACT study. The efficacy of the hypothetical therapy was estimated by applying assumed hazard ratios of 0.45 for progression-free survival (PFS) and 0.5 for overall survival (OS) to the gemcitabine curves. Adverse event data for gemcitabine were also sourced from the MPACT trial. Direct medical costs were derived from NHS reference costs, the Personal Social Services Research Unit (PSSRU), and other UK-specific sources. Health state utility values were obtained from published literature. Sensitivity analyses and scenario analyses were conducted to explore the robustness of results and the impact of key model parameters.
RESULTS: Given the high disease burden of mPAC, the hypothetical therapy was assumed to qualify for a 1.7x severity weighting, consistent with recent UK health technology assessment guidance. At a willingness-to-pay threshold of £20,000 per quality-adjusted life year (QALY) gained, the hypothetical therapy may be able to justify a therapy cost of ~£2,000 per treatment cycle.
CONCLUSIONS: Applying a 1.7x severity weight appropriately reflects the high burden associated with mPAC and supports a higher valuation of health gains. This analysis suggests that a more effective first-line therapy could be considered cost-effective at a premium price.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE554
Topic
Economic Evaluation
Disease
Oncology