BACKGROUNDS and OBJECTIVES: According to the Japanese clinical practice guidelines for pancreatic cancer 2019, FOLFIRINOX(FFX) or Gemcitabine plus nab-Paclitaxel(GEM+nab-PTX) is recommended as a 1^st line chemotherapy for metastatic pancreatic cancer (MPC). Meanwhile, cost-effectiveness analysis of those chemotherapies for MPC hasn’t been carried out in Japan. Our purpose of this study was to examine the feasibility of cost-effectiveness analysis of modified(m)FFX (changed dose in consideration of the high adverse effects of FFX ) and GEM+nab-PTX in the 1^st line chemotherapy for MPC using medical records in National Cancer Center Hospital East, Japan.

METHODS: We randomly selected 15 MPC patients receiving mFFX or GEM+nab-PTX as a 1^st line treatment, collected individual medical record data (patient background, treatment progress and contents) Utilities were calculated from individual treatment period, the medical status and frequency and grade of adverse events. Costs were included drug costs, treatment procedures, tests and basic medical cares. We analyzed using a bootstrap method to calculate mean and standard deviation in total costs, quality-adjusted life year (QALY), overall survival (OS) and progression free survival (PFS) from payer prospective.

RESULTS: The mean±standard deviation of total costs, QALY, OS, and PFS in mFFX group were 3,803,652±486,822 yen, 0.82±0.127/year, 1.01±0.173, and 0.82±0.170 year. In GEM+nab-PTX group, they were 4,717,827±270,510, 0.50±0.038/year, 0.72±0.064 year, and 0.55±0.021 year.

CONCLUSIONS: The feasibility of economic analysis using individual medical records was considered. Since this study was conducted in small number, it’s required to do it in increased number in next. Furthermore, in addition to conduct analysis according to patient situation, we need to consider about handling patients date moving to another hospital during treatment, unifying the historical background between patients receiving each treatment and adjusting patient background factors that could affect outcome.