Prophylactic pasireotide administration following pancreatic resection reduces cost while improving outcomes

Area of Science:

• Surgical Oncology
• Health Economics
• Pharmacoeconomics

Background:

• Pancreatic resection carries significant risks of postoperative complications, including pancreatic fistula/leak/abscess (PF/PL/A).
• Pasireotide has demonstrated efficacy in reducing these complications, but its high cost presents a potential barrier to widespread adoption.

Purpose of the Study:

• To conduct a cost-effectiveness analysis of prophylactic pasireotide administration following pancreatic resection.
• To determine if pasireotide offers a reasonable cost profile despite its drug expense.

Main Methods:

• A cost-effectiveness model was developed comparing pasireotide versus usual care post-pancreatic resection.
• Model inputs included clinical outcome probabilities from a randomized trial and hospital costs from a university center.
• Sensitivity analyses were performed to identify key cost drivers.

Main Results:

• The pasireotide arm resulted in lower overall per-patient costs ($41,769 vs. $42,159), representing net savings of $390.
• A significant 56% reduction in PF/PL/A rates was observed with pasireotide use (21.9% to 9.2%).
• Pasireotide cost increases up to 15.4% would still maintain cost-effectiveness.

Conclusions:

• Prophylactic pasireotide administration following pancreatectomy is a cost-saving strategy.
• It effectively reduces expensive postoperative sequelae, including major complications and readmissions.
• Pasireotide should be considered a cost-saving measure in pancreatic resection protocols.