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.