Drug costs and benefits of medical treatments in high-unmet need solid tumours in the Nordic countries

- Treatment costs of new cancer therapies should reflect their clinical value.
- This study compares the cost-benefit of drugs for high unmet-need solid tumours.
- Among the selected drugs, nab-paclitaxel in pancreatic cancer was considered.
- Overall treatment costs were related to the clinical improvement in trials.
- This study demonstrates that the higher is the benefit, the higher is the cost.

IntroductionRegional and hospital decision-makers increasingly require analyses assessing the cost-benefit profile of new cancer drugs. This analysis evaluates the cost-benefit profile of nano albumin-bound paclitaxel (nab-paclitaxel) in pancreatic cancer, versus other drugs indicated in high-unmet need solid tumour indications in Nordic countries (Sweden, Denmark, Finland, Norway and Sweden).MethodsFor a selected number of cancer dugs, approved for metastatic cancer or non-curable treatment intention patients by the European Medicine Agency (EMA) after 2000, and indicated in high-unmet need solid tumours (defined as OS in first line for trial comparator ≤12 months), a regression analysis was conducted. Overall treatment costs of cancer drugs, divided by OS and PFS months, were related to the clinical improvement offered versus trial comparator.ResultsEleven of 42 drugs (26.2%) with at least one indication in solid tumours met inclusion criteria. On average, a good (R2 = 0.5359) fit between costs per OS month and OS relative benefit versus trial comparator was observed. Nab-paclitaxel offered an OS improvement of +27% versus trial comparator (average improvement: +31%), at a cost per OS month of €1,684 (average cost: €2,247). Correlation between costs per PFS month and relative PFS benefit versus trial comparator was still observed, but the goodness of fit was lower (R2 = 0.1853) than for the OS analysis.ConclusionTreatment costs of new cancer therapies should reflect their clinical value, consistently among different indications with comparable characteristics. Nab-paclitaxel, recently approved in pancreatic cancer, showed a similar cost per OS or PFS month ratio compared to other drugs for high-unmet need solid tumours.