705P - Premature mortality in pancreatic cancer: Analysis of lost life-years and quality-adjusted life-years (QALYs) in Europe

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Bioethics, Legal, and Economic Issues
Pancreatic Cancer
Presenter Alfredo Carrato
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors A. Carrato1, A. Falcone2, M. Ducreux3, J.W. Valle4, A. Parnaby5, K. Djazouli6, K. Alnwick-Allu7, A. Hutchings8
  • 1Medical Oncology, Hospital Ramon y Cajal, ES-28034 - Madrid/ES
  • 2Dept. Of Oncology-presidio Ospedaliero, Polo Oncologico - Azienda Ospedaliero-Universitaria Pisana - Istituto Toscano Tumori, 56126 - Pisa/IT
  • 3Department Of Gastroenterlogy, Gustave Roussy Cancer Campus Grand Paris, 94805 - Villejuif/FR
  • 4Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 5Market Access & Pricing, Celgene Corp, Boudry/CH
  • 6Oncology, Celgene Corp, Paris/FR
  • 7Consulting, Dolon Ltd., London/GB
  • 8Director, Dolon Ltd., London/GB

Abstract

Aim

Pancreatic Cancer (PanC) is associated with a very poor prognosis and a high patient burden. The objective of this analysis was to quantify the aggregate number of life years (LYs) and QALYs lost due to PanC in Europe each year.

Methods

Estimates of incidence, life expectancy and quality of life were derived from a systematic review of PanC disease burden in Europe. Equivalent data for age-matched European population norms were obtained from the literature. Estimates of LYs lost were calculated by comparing predicted life-expectancy for PanC patients with age-matched population norms. QALYs lost were estimated by incorporating health-utility estimates for both cohorts. Aggregate LYs and QALYs lost were predicted by accounting for annual PanC incidence across EU-28 countries. We performed the analyses for both the general PanC population and metastatic (mets.) patients.

Results

The average age of PanC patients at diagnosis is 71 years. Life expectancy at diagnosis is 0.3 years (4.6 months), compared to 15.1 years for an age-matched population norm – a loss of 14.7 years per person. The annual number of incident PanC patients in Europe varied between 50,450 and 79,331depending upon the source and methodology of incidence data. The total number of LYs lost to PanC annually in Europe was as high as 1.2 million life years. Nearly half of these are due to metastatic disease. The utility of PanC patients is 0.65 compared to a population norm utility of 0.78. On average 11.5 QALYs are lost per person with PanC. Extrapolated across Europe, up to 800,000 QALYs are lost annually to PanC.

Life-years and QALYs lost annually in Europe
Incident Cases per year Aggregate Life-years Lost Aggregate QALYs Lost
Annual Incidence Rate All PanC Mets. All PanC Mets. All PanC Mets
Globocan - 79,331 44,901 1,167,488 663,792 914,594 519,606
Age-adjusted incidence, European Standard 10.43 52,872 29,925 778,095 442,397 609,549 346,301
Crude Incidence, Europe 9.95 50,450 28,555 742,456 422,134 581,630 330,440

Conclusions

Up to 1 million life-years are lost to PanC in Europe yearly, demonstrating the magnitude of the disease's impact. Measurements of the life years and QALYs lost may provide a method to compare the relative burden of cancers. Similar methodology for comparing the relative burden of diseases is currently under consultation with NICE in the UK in the context of Value Based Pricing.

Disclosure

A. Parnaby and K. Djazouli: I am an employee of Celgene Corporation and I declare ownership of company stocks. All other authors have declared no conflicts of interest.