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10.12.2018 | original article

Does giving pasireotide to patients undergoing pancreaticoduodenectomy always pay for itself?

Zeitschrift:
European Surgery
Autoren:
MD Fang Yuan, PhD Amiram Gafni, PhD Chu-Shu Gu, MD MSc Pablo E. Serrano
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10353-018-0563-8) contains supplementary material, which is available to authorized users.

Presentations

This work was presented in part at: SSAT, Chicago, Illinois, May 9, 2017 and Pancreas Club, Chicago, Illinois, May 5, 2017.

Summary

Background

Previous cost evaluation studies reported either no increase or cost-saving using pasireotide in patients undergoing pancreaticoduodenectomy. We examined the likelihood and magnitude of cost-saving when using pasireotide at our institution to determine the generalizability of prior reports.

Methods

Cost data were obtained for a cohort of 440 patients undergoing pancreaticoduodenectomy at a single institution during 2009–2016. A statistical model was used to simulate the cost of patient care had they received pasireotide. Sensitivity analyses were performed to assess the impact of pasireotide price and pancreatic fistula rate on cost.

Results

With a fistula rate of 10.2% and a current price for pasireotide of $1257, the likelihood of cost-saving is 60%. When cost-saving does occur, the mean cost-saving per patient is $1442, 2.5–97.5% quantile difference (QD): $69–3756. At the same pasireotide price but with a fistula rate of 30%, the likelihood of cost-saving increases to 91% with a mean cost-saving of $4030, 2.5–97.5% QD: $402–8511. At the same fistula rate but with a pasireotide price of $1000, the likelihood of cost-saving increases to 65% with a cost-saving of $1566, 2.5–97.5% QD: $75–3979.

Conclusion

At its current price, and with the fistula rate at our institution, pasireotide is more likely to pay for itself than not, but there is a significant probability that it will not be cost-saving. Negotiating a better price (i.e., to the lowest found in the literature) will reduce the likelihood of pasireotide not being cost-saving by 5%.

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Zusatzmaterial
Table S1: Characteristics of patients with or without pancreatic fistula
10353_2018_563_MOESM1_ESM.docx
Table S2: Market price of 14 doses of pasireotide and the price after converting into Canadian currency from 14 different countries/regions according to hospital pricing
10353_2018_563_MOESM2_ESM.docx
Literatur
Über diesen Artikel