Olaparib for germline BRCA-mutated metastatic pancreatic cancer: cost effective in China and US

Abstract

Olaparib maintenance treatment is a cost-effective option in China and the US for patients with germline BRCAmutated metastatic pancreatic cancer, report researchers from China. The researchers used a three-state Markov model to evaluate the cost effectiveness of olaparib, compared with placebo, as maintenance treatment for advanced recurrent BRCA-mutated metastatic pancreatic cancer, initiated 4–8 weeks after the final dose of first-line chemotherapy. Transition probabilities for the three health states in the model were based on overall-survival and progression-free survival data from the POLO trial. The analyses were performed from the perspective of the healthcare systems in China and the US. Compared with placebo, olaparib was associated with an additional 8.77 quality-adjusted life-years (QALYs) at incremental costs of $US58 704 and $US116 881 (year 2020 values) in China and the US, respectively, over a 5-year time horizon. The incremental cost-effectiveness ratios (ICERs) were $US6694 and $US13 327 per QALY gained in China and the US, respectively. These ICERs are far below commonly accepted willingness-to-pay thresholds (¥212 676 or $US30 892 [3 × GDP per capita in China in 2019] and $US50 000 per QALY gained for China and the US, respectively). For China, the ICER was even less than 1 × GDP per capita (¥70 892 [$US10 276] in 2019), note the researchers. Sensitivity analyses showed that the cost of olaparib was the main driver of the ICERs for both countries. Health utility values of the progression-free health state also had a substantial impact on the ICERs.