Cost-effectiveness analysis of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with gastric cancer and peritoneal metastasis.
Eur J Surg Oncol
; 48(1): 188-196, 2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-34479745
ABSTRACT
OBJECTIVE:
The aim of this study was to assess the cost-effectiveness of pressurized intraperitoneal aerosol chemotherapy with low-dose cisplatin and doxorubicin (PIPAC C/D) for the treatment of advanced gastric cancer.METHODS:
A Partitioned Survival Model followed by state transition Markov model was developed to estimate the costs and effectiveness of the use of PIPAC C/D versus palliative chemotherapy in the UK. The intervention was assessed at two different levels of care, including upfront therapy (PIPAC C/D plus Oxaliplatin in combination with Capecitabine (XELOX) chemotherapy versus first-line chemotherapy alone) and second-line therapy (PIPAC C/D alone versus second-line chemotherapy (ramucirumab monotherapy)). Data from multiple sources, including published literature and UK-based databases, were used to inform the economic model.RESULTS:
For the upfront therapy analysis, the estimated total costs in the intervention and comparator arms were £32,606 (SD £3877) and £17,844 (SD £920), respectively. PIPAC C/D plus XELOX led to an increase of 0.46 in quality-adjusted life-years (QALYs) gained. The incremental cost per QALY gained was £31,868. For the second-line therapy analysis, the use of PIPAC C/D led to an increase of 0.19 in QALYs and a £21,474 reduction in costs, meaning the intervention was a dominant strategy.CONCLUSIONS:
The cost-effectiveness results for the upfront therapy analysis indicate that PIPAC C/D plus chemotherapy is a cost-effective strategy. Additionally, PIPAC C/D alone as a second-line therapy has the potential to reduce costs and improve clinical outcomes for patients with advanced gastric cancer with peritoneal metastasis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Oxaloacetatos
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Neoplasias Peritoneais
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Neoplasias Gástricas
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Carcinoma
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Protocolos de Quimioterapia Combinada Antineoplásica
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Aerossóis
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Capecitabina
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article