The PANOVA-3 trial has demonstrated that adding tumor treating fields (TTFields) to standard chemotherapy improves survival outcomes in locally advanced pancreatic adenocarcinoma (LA-PAC). However, given the high cost of such novel therapies, it is essential to evaluate their economic impact to ensure a balanced understanding of their clinical and financial value. A three-state Markov model was devised to compare the cost-effectiveness of TTFields combined with chemotherapy versus chemotherapy alone, using clinical data from the PANOVA-3 trial. Analyses were conducted from both American and Chinese healthcare payer perspectives, with willingness-to-pay (WTP) thresholds set at 150, 000 and 40, 026 per quality-adjusted life year (QALY), respectively. Lifetime costs, incremental cost-effectiveness ratios (ICERs), and incremental net health benefits (INHBs) were estimated. Sensitivity analyses were performed to evaluate the robustness of the model outcomes. The combination of TTFields and chemotherapy resulted in incremental lifetime costs of 147, 766 and 39, 470 and additional gains of 0. 148 and 0. 142 QALYs in the USA and China, respectively. This corresponds to ICERs of 1, 001, 995/QALY (USA) and 278, 708/QALY (China), both exceeding their respective WTP thresholds. Sensitivity analyses identified TTFields device cost as the most influential parameter, confirming model stability across a range of assumptions. TTFields plus chemotherapy was not a cost-effective strategy for patients with LA-PAC at the current price, but it can be used as a clinical alternative strategy with health effects.
Liu et al. (Mon,) studied this question.