Cost-effectiveness analysis of pancreatic enzyme replacement therapy in patients with pancreatic exocrine insufficiency in China

Table 1 Key input parameter for the model

	Value (SD)	One way sensitivity analysis (%)	PSA distribution	Ref.
Survival (HR)
Scenario 1	0.69 (0.14)	+/- 25	Lognormal	Iglesia et al[14]
Scenario 2	0.57 (0.06)	+/- 25	Lognormal	Roberts et al[27]
Scenario 3	0.48 (0.20)	+/- 25	Lognormal	Winny et al[23]
Clinical efficacy
Scenario 1	0.53 (0.05)	+/- 25	Beta	Iglesia et al[14]
Scenario 2	0.58 (0.06)	+/- 25	Beta	Seiler et al[28]
Scenario 3	0.81 (0.08)	+/- 25	Beta	Seiler et al[28]
Utilities
Scenario 1	0.78 (0.13)	+/- 25	Beta	Romanus et al[29]
Scenario 2	0.78 (NR)	+/- 25	Beta	Hagiwara et al[30]
Scenario 3	0.79 (0.052)	+/- 25	Beta	Laramée et al[31]
Disutilities
Abdominal pain	-0.051 (NR)	+/- 25	Beta	NICE 2017[33]
Diarrhoea/decreased appetite/fatigue	-0.204 (NR)	+/- 25	Beta	NICE 2017[33]
Costs
PERT
Scenario 1	7.93 dollars/day (NA)	+/- 25	Gamma	Dominguez-Muñoz[35]
Scenario 2	7.93 dollars/day (NA)	+/- 25	Gamma	Clinical expert survey (data on file)
Scenario 3	3.10 dollars/day (NA)	+/- 25	Gamma	Clinical expert survey (data on file)
Ongoing care
Scenario 1	4503.22 dollars/year (NA)	+/- 25	Gamma	Clinical expert survey (data on file)
Scenario 2	4503.22 dollars/year (NA)	+/- 25	Gamma	Clinical expert survey (data on file)
Scenario 3	2248 dollars/year (NA)	+/- 25	Gamma	Clinical expert survey (data on file)
Other inputs
Cycle length	1 month	Not varied	Not varied
Discounting	5%	Not varied	Not varied
Time horizon
Scenario 1	5 years	Not varied	Not varied
Scenario 2	10 years	Not varied	Not varied
Scenario 3	15 years	Not varied	Not varied

PERT: Pancreatic enzyme replacement therapy; HR: Hazard ratio; PSA: Probabilistic sensitivity analysis; NR: Not reported; NA: Not applicable.

Table 2 Results of the cost-effectiveness analyses

	Scenario 1 (unresectable pancreatic cancer)		Scenario 2 (pancreatic cancer post-surgery)		Scenario 3 (chronic pancreatitis after endoscopic treatment)
	PERT	No PERT	PERT	No PERT	PERT	No PERT
LYs	1.33	0.94	4.41	3.12	9.79	8.76
QALYs	0.94	0.49	3.22	1.64	7.65	4.72
Costs (dollar)	4960	645	15677	1743	17846	2653
ICER (LY/dollar)	10996		10763		14829
ICER (QALY/dollar)	9533		8813		5178

LY: Life year; QALY: Quality adjusted life year; ICER: Incremental cost-effectiveness ratio; PERT: Pancreatic enzyme replacement therapy.