Comparison of treatment patterns and economic outcomes among metastatic pancreatic cancer patients initiated on nab-paclitaxel/gemcitabine or FOLFIRINOX.

Background: The economic burden of metastatic pancreatic cancer (mPC) is substantial while treatment options are limited. Little is known about the treatment patterns and healthcare costs among mPC patients who initiated first-line gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-P+G) and FOLFIRINOX.Methods: The MarketScan (R) claims databases were used to identify adults with 2 claims for pancreatic cancer, 1 claim for a secondary malignancy, completed 1 cycle of nab-P+G or FOLFIRINOX during 4/1/2013 and 3/31/2015, and had continuous plan enrollment for 6months pre- and 3months after the first-line treatment. Duration of therapy, per patient per month (PPPM) costs of total healthcare, mPC-related treatment, and supportive care were measured during first-line therapy.Results: 550 mPC patients met selection criteria (nab-P+G, n=294; FOLFIRINOX, n=256). There was no difference in duration of therapy (p=0.60) between nab-P+G and FOLFIRINOX. Compared with FOLFIRINOX, patients with nab-P+G had higher chemotherapy drug costs but lower treatment administration costs and supportive care costs (all p<0.01).Conclusions: Patients treated with nab-P+G (vs FOLFIRINOX) had similar treatment duration but lower costs of outpatient prescriptions, treatment administration and supportive care. Lower supportive care costs in the nab-P+G cohort were mainly driven by lower utilization of pegfilgrastim and anti-emetics.