Ανάλυση κόστους - αποτελεσματικότητας του σχήματος Nalirifox έναντι Nab-Paclitaxel και Gemcitabine ως θεραπεία πρώτης γραμμής του μεταστατικού αδενοκαρκινώματος του παγκρεατικού πόρου

Μαρούδη, Παναγιώτα - Ζωή

Cost-effectiveness analysis of NALIRIFOX versus Nab-Paclitaxel and Gemcitabine as first-line treatment for metastatic pancreatic ductal adenocarcinoma

Master Thesis

Author

Μαρούδη, Παναγιώτα - Ζωή

Date

2026

Abstract

Objective: Metastatic pancreatic ductal adenocarcinoma (mPDAC) is a highly lethal malignancy associated with a substantial clinical and economic burden. The objective of this thesis is to evaluate the cost-effectiveness of the novel NALIRIFOX regimen (liposomal irinotecan, 5-fluorouracil, leucovorin, and oxaliplatin) compared to the standard nab-paclitaxel plus gemcitabine regimen, as a first-line treatment, from the perspective of the Greek National Healthcare System. Methods: A Partitioned Survival Model (PSM) comprising three health states (progression-free survival, progressed disease, death) was developed over a lifetime horizon (360 months). Clinical efficacy data were derived from the NAPOLI-3 phase 3 randomized clinical trial. An annual discount rate of 3.5% was applied to both costs and health outcomes. Treatment effectiveness was measured in Quality-Adjusted Life Years (QALYs). Results: The base-case analysis demonstrated that the NALIRIFOX regimen yielded 1.19 QALYs at a total mean cost of €53,402.26 per patient, whereas the nab-paclitaxel/gemcitabine regimen yielded 0.94 QALYs at €26,380.53. The incremental cost of the new therapy was €27,021.73 and the incremental benefit was 0.25 QALYs, resulting in an Incremental Cost-Effectiveness Ratio (ICER) of €108,992.57 per QALY. One-way sensitivity analysis revealed that the model is highly sensitive to the acquisition cost of liposomal irinotecan. Conclusions: The estimated ICER significantly exceeds the GDP-based willingness-to-pay threshold for Greece (€19,400 - €58,200 per QALY). Consequently, the NALIRIFOX regimen is not considered cost-effective at its current list prices. A price reduction of 36.79% for liposomal irinotecan is required for the intervention to fall within the marginal cost-effectiveness threshold for the Greek healthcare system.

Postgraduate Studies Programme

Οικονομικά και Διοίκηση της Υγείας

Department

Σχολή Οικονομικών, Επιχειρηματικών και Διεθνών Σπουδών. Τμήμα Οικονομικής Επιστήμης

Number of pages

110

Language

Greek

URI

https://dione.lib.unipi.gr/xmlui/handle/unipi/19652

Collections

Τμήμα Οικονομικής Επιστήμης

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Except where otherwise noted, this item's license is described as
Αναφορά Δημιουργού 3.0 Ελλάδα