Cost-effectiveness of FOLFIRINOX for first-line treatment of metastatic pancreatic cancer.

199 Background: The ACCORD 11/0402 trial demonstrates that FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) is significantly more efficacious than the current standard of gemcitabine (G) monotherapy in the first line treatment of metastatic pancreatic cancer (mPC). This study assesses for public payers the cost-effectiveness of first-line FOLFIRINOX compared to first-line G in Canadian mPC patients. Methods: A Markov model was used to estimate how patients progress through the following states: ‘stable’, ‘progressed’, ‘dead’. OS and PFS data were derived from the trial data. Published utility data and Canadian cost data were applied based on time in each state and treatment related adverse event (AE) rates. Costs included first and second-line therapy, monitoring, AE and end of life costs. Costs and outcomes are discounted at 5%. Two separate analyses were made. Analysis 1: Based on trial data (First-line FOLFIRINOX → second-line G versus First-line G → second-line platin-based chemo, ...