Prophylactic pasireotide administration following pancreatic resection reduces cost while improving outcomes.

Abstract

BACKGROUND AND OBJECTIVES:

Pasireotide decreases leak rates after pancreatic resection, though significant drug cost may be prohibitive. We conducted a cost-effectiveness analysis to determine whether prophylactic pasireotide possesses a reasonable cost profile.

METHODS:

A cost-effectiveness model compared pasireotide administration after pancreatic resection versus usual care, populated by probabilities of clinical outcomes from a randomized trial and hospital costs (2013 US$) from a university pancreatic disease center. Sensitivity analyses were performed to identify influential clinical components of the model.

RESULTS:

With the cost of pasireotide included, per patient costs of pancreatectomy, including those for readmission, were lower in the intervention arm (41,769 versus 42,159$; net savings of 390$, or 1%). This was associated with a 56% reduction in pancreatic fistula/pancreatic leak/abscess (PF/PL/A; 21.9-9.2%). Pasireotide cost would need to increase by over 15.4% to make the intervention strategy more costly than usual care. Sensitivity analyses exploring variability of key model inputs demonstrated that the three strongest drivers of cost were (i) cost of pasireotide; (ii) probability of readmission; and (iii) probability of PF/PL/A.

CONCLUSIONS:

Prophylactic pasireotide administration following pancreatectomy is cost savings, reducing expensive post-operative sequealae (major complications and readmissions). Pasireotide should be utilized as a cost-saving measure in pancreatic resection. J. Surg. Oncol. 2016;113:784-788. © 2016 Wiley Periodicals, Inc.

• Authors: Daniel E Abbott, Jeffrey M Sutton, Peter L Jernigan, Alex Chang, Patrick Frye, Shimul A Shah, Daniel P Schauer, Mark H Eckman, Syed A Ahmad, Jeffrey J Sussman
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 113 Issue 7 Pg. 784-8 (Jun 2016) ISSN: 1096-9098 [Electronic] United States
• PMID: 27041733 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2016 Wiley Periodicals, Inc.

Chemical References

• Hormones
• Somatostatin
• pasireotide

Topics

• Abdominal Abscess (economics, epidemiology, etiology, prevention & control)
• Anastomotic Leak (economics, epidemiology, prevention & control)
• Cost Savings
• Cost-Benefit Analysis
• Decision Trees
• Drug Administration Schedule
• Hormones (economics, therapeutic use)
• Hospital Costs
• Humans
• Models, Economic
• Ohio
• Pancreatectomy
• Pancreatic Fistula (economics, epidemiology, etiology, prevention & control)
• Postoperative Complications (economics, epidemiology, prevention & control)
• Somatostatin (analogs & derivatives, economics, therapeutic use)
• Treatment Outcome