Article ; Online: Olaparib not cost-effective as maintenance therapy for platinum-sensitive, BRCA1/2 germline-mutated metastatic pancreatic cancer.
2024 Volume 19, Issue 4, Page(s) e0301271
Abstract: Objective: To assess the cost-effectiveness and budget impact of olaparib as a maintenance therapy in platinum-responsive, metastatic pancreatic cancer patients harboring a germline BRCA1/2 mutation, using the Swiss context as a model.: Methods: ... ...
| Abstract | Objective: To assess the cost-effectiveness and budget impact of olaparib as a maintenance therapy in platinum-responsive, metastatic pancreatic cancer patients harboring a germline BRCA1/2 mutation, using the Swiss context as a model. Methods: Based on data from the POLO trial, published literature and local cost data, we developed a partitioned survival model of olaparib maintenance including full costs for BRCA1/2 germline testing compared to FOLFIRI maintenance chemotherapy and watch-and-wait. We calculated the incremental cost-effectiveness ratio (ICER) for the base case and several scenario analyses and estimated 5-year budget impact. Results: Comparing olaparib with watch-and wait and maintenance chemotherapy resulted in incremental cost-effectiveness ratios of CHF 2,711,716 and CHF 2,217,083 per QALY gained, respectively. The 5-year costs for the olaparib strategy in Switzerland would be CHF 22.4 million, of which CHF 11.4 million would be accounted for by germline BRCA1/2 screening of the potentially eligible population. This would amount to a budget impact of CHF 15.4 million (USD 16.9 million) versus watch-and-wait. Conclusions: Olaparib is not a cost-effective maintenance treatment option. Companion diagnostics are an equally important cost driver as the drug itself. |
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| MeSH term(s) | Female ; Humans ; BRCA1 Protein/genetics ; Ovarian Neoplasms/genetics ; Platinum/therapeutic use ; BRCA2 Protein/genetics ; Phthalazines/therapeutic use ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/pathology ; Germ Cells/pathology ; Cost-Benefit Analysis ; Piperazines |
| Chemical Substances | BRCA1 protein, human ; BRCA1 Protein ; olaparib (WOH1JD9AR8) ; Platinum (49DFR088MY) ; BRCA2 protein, human ; BRCA2 Protein ; Phthalazines ; Piperazines |
| Language | English |
| Publishing date | 2024-04-04 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 2267670-3 |
| ISSN | 1932-6203 ; 1932-6203 |
| ISSN (online) | 1932-6203 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0301271 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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