OBJECTIVES:  Pancreatic cancer is difficult to treat effectively and the optimal first-line treatment has not yet been defined. The objective of this research is to provide benchmark reference for the evaluation of newer therapies. The ASCO Value Framework NHB and the NCCN recommended chemotherapy treatment combinations were utilized to assess the clinical benefit of three treatment regimens. METHODS: Phase III RCTs based on the NCCN recommended first line therapies for advanced mPC, were selected for analysis: “MPACT”, GEM + nab-Paclitaxel (GN-P); “ACCORD”, FOLFIRINOX and “NCIC-CTG” GEM + Erlotinib (GEM-E). The ASCO framework was applied to calculate the clinical/toxicity and tNHB scores of each regimen. We also calculated the monthly drug cost for each of these standard regimes based on the 2016 Medicare Part B Drug Payment Allowance. RESULTS: The NCCN guidelines list these regimes in Category 1 preferred chemotherapy combinations. All delivered a NHB over GEM: FOLFIRINOX 123.1 pts; GN-P 52.5 pts; GEM-ER 12.3pts. Clinical benefit score for each regimen; FOLFIRINOX 63.3pts; GN-P 26 pts and GEM-E 6.4 pts. The toxicity scores based on adverse events were higher in FOLFIRINOX; GN-P; and GEM-E and lower in the GEM group. Bonus points were achieved in FOLFIRINOX, based on overall survival benefit. The cost of drug treatment per month was significantly higher in each group while GEM was the lowest cost treatment: GEM $278; FOLFIRINOX $2,975; GN-P $11,350; GEM-E $8,320. CONCLUSIONS:  The ASCO NHB is an attempt to represent therapy value in a single score but can be prejudiced by trial design and treatment cost. The regimens assessed support the NCCN category 1 recommendations for first line mPA treatment. FOLFIRINOX provided the highest NHB and less expensive than GN-P and GEM-E. This assessment provides a reference for payer assessment of new therapies and for patient and provider therapy choice decisions.