Prophylactic pasireotide administration following pancreatic resection reduces cost while improving outcomes. Issue 7 (4th April 2016)

• Record Type: Journal Article
• Authors: Abbott, Daniel E.; Sutton, Jeffrey M.; Jernigan, Peter L.; Chang, Alex; Frye, Patrick; Shah, Shimul A.; Schauer, Daniel P.; Eckman, Mark H.; Ahmad, Syed A.; Sussman, Jeffrey J.
• Is Part Of: Journal of surgical oncology. Volume 113:Issue 7(2016)
• Page Start: 784
• Page End: 788
• Publication Date: 2016-04-04
• Subjects: pasireotide -- pancreatectomy -- cost‐effectiveness -- pancreatic leak -- pancreatic fistula; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24239
• Languages: English
• ISSNs: 0022-4790

Abstract

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.