COST-EFFECTIVENESS ANALYSIS OF LIPOSOMAL IRINOTECAN IN COMBINATION WITH OXALIPLATIN, 5-FLUOROURACIL AND LEUCOVORIN (NALIRIFOX) FOR THE FIRST-LINE TREATMENT OF ADULT PATIENTS WITH METASTATIC ADENOCARCINOMA OF THE PANCREAS IN GREECE
Author(s)
George Gourzoulidis, PhD1, VASILIKI CHOTZAGIANNOGLOU, MBA, MSc, PharmD2, Andriani Angelopoulou, PhD1, Eleana Solakidou, PhD(c)2, Charalampos Tzanetakos, MSc3.
1Health Through Evidence, Athens, Greece, 2SERVIER HELLAS PHARMACEUTICALS Ltd, Athens, Greece, 3Health Through Evidece, Athens, Greece.
1Health Through Evidence, Athens, Greece, 2SERVIER HELLAS PHARMACEUTICALS Ltd, Athens, Greece, 3Health Through Evidece, Athens, Greece.
OBJECTIVES: Pancreatic adenocarcinoma is a highly aggressive malignancy with poor prognosis and limited treatment options. Hence, the aim of the present study was to evaluate the cost-effectiveness of liposomal Irinotecan in combination with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) compared with gemcitabine plus nab-paclitaxel (GemNabPac) for the first-line treatment (FLT) of adult patients with metastatic adenocarcinoma of the pancreas (mPDAC) in Greece.
METHODS: A partitioned survival model with weekly cycle comprising three health states (progression-free, progressed disease and death) was adapted from a Greek payer perspective over a lifetime horizon. GemNabPac was selected as the comparator since it represents the current standard of care in Greece, being the most widely prescribed first-line regimen for mPDAC. Clinical efficacy, safety data, and utilities were derived from the NAPOLI-3 trial and published literature. Direct medical costs included drug acquisition, administration, monitoring, adverse events, subsequent therapies, and end-of-life care. All costs reflect the year 2025 (€). Model outcomes included quality-adjusted life years (QALYs), life years (LYs), total costs, and incremental cost-effectiveness ratios (ICERs). Future outcomes were discounted at 3.5% annually. Probabilistic sensitivity analysis (PSA) was conducted to assess parameter uncertainty
RESULTS: The analysis showed that NALIRIFOX was associated with incremental gains of 0.14 QALYs and 0.16 LYs compared with GemNabPac, at an additional cost of €8,736. The resulting ICERs were €64,015 per QALY gained and €55,369 per LY gained. PSA indicated a 58% probability of NALIRIFOX being cost-effective at a willingness-to-pay threshold of €72,000 per QALY gained (3× Greek gross domestic product per capita).
CONCLUSIONS: The present study indicates that, NALIRIFOX provides clinically meaningful benefits and represents a cost-effective option for patients with mPDAC in Greece, a population with very limited FLT options. These findings support consideration of NALIRIFOX by policymakers and clinicians as an important therapeutic advance in this challenging disease area.
METHODS: A partitioned survival model with weekly cycle comprising three health states (progression-free, progressed disease and death) was adapted from a Greek payer perspective over a lifetime horizon. GemNabPac was selected as the comparator since it represents the current standard of care in Greece, being the most widely prescribed first-line regimen for mPDAC. Clinical efficacy, safety data, and utilities were derived from the NAPOLI-3 trial and published literature. Direct medical costs included drug acquisition, administration, monitoring, adverse events, subsequent therapies, and end-of-life care. All costs reflect the year 2025 (€). Model outcomes included quality-adjusted life years (QALYs), life years (LYs), total costs, and incremental cost-effectiveness ratios (ICERs). Future outcomes were discounted at 3.5% annually. Probabilistic sensitivity analysis (PSA) was conducted to assess parameter uncertainty
RESULTS: The analysis showed that NALIRIFOX was associated with incremental gains of 0.14 QALYs and 0.16 LYs compared with GemNabPac, at an additional cost of €8,736. The resulting ICERs were €64,015 per QALY gained and €55,369 per LY gained. PSA indicated a 58% probability of NALIRIFOX being cost-effective at a willingness-to-pay threshold of €72,000 per QALY gained (3× Greek gross domestic product per capita).
CONCLUSIONS: The present study indicates that, NALIRIFOX provides clinically meaningful benefits and represents a cost-effective option for patients with mPDAC in Greece, a population with very limited FLT options. These findings support consideration of NALIRIFOX by policymakers and clinicians as an important therapeutic advance in this challenging disease area.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE379
Topic
Economic Evaluation
Topic Subcategory
Value of Information
Disease
Oncology