OBJECTIVES:To estimate the budgetary impact from the introduction of liposomal Irinotecan as a treatment option for patients with metastatic pancreatic cancer (mPDAC) who have previously received gemcitabine-based regimens in Greek health system.

METHODS:A budget impact model was developed from third-party payer perspective over a 5-year time horizon to estimate the financial impact of liposomal Irinotecan by obtaining market shares from available treatments options. Based on local experts, patients with mPDAC are currently treated with FOLFOX, FOLFIRI, FOLFIRINOX, capecitabine and nab-paclitaxel, which represent the common clinical practice in the absence of any other recommendation. The model framework considered market share scenarios with and without liposomal Irinotecan and reimbursed costs of treatment applied to the eligible patient population. Data on the number of eligible patients were estimated from the published literature and local experts, while the projected uptake of liposomal Irinotecan was provided by Servier. Drug acquisition costs were considered in the analysis and were retrieved from the Greek Ministry of Health. The model measured outcome was incremental budget impact from the introduction of liposomal Irinotecan as a treatment option in the patients with mPDAC

RESULTS:Over the 5-year horizon, the number of eligible patients was 485 and the number of patients who received liposomal Irinotecan was 19, 116, 189, 210 and 210 in the years 1 to 5, respectively. The annual incremental costs associated with the introduction of liposomal Irinotecan were €118,641, €728,491, €1,186,407, €1,321,695 and €1,321,695 for years 1 to 5 respectively, resulting in a total 5-year budget impact of €4,676,928.

CONCLUSIONS: The regimen of liposomal Irinotecan plus 5-FU/LV as a treatment option for patients with mPDAC after disease progression following gemcitabine-based therapies, provides survival benefits. The analysis suggests that, those clinical benefits are associated with additional costs which may be considered as reasonable and bearable from the Greek payer perspective.