Real World Hospital Costs Associated With Nab-Paclitaxel Plus Gemcitabine (Nab-P Plus G) And Folfirinox (Ffx) As First Line (1 L) Treatment (Tx) For Metastatic Pancreatic Adenocarcinoma (Mpac).

e15741 Background: In independent phase III trials, both nab-P+G and FFX demonstrated superiority over G as 1L MPAC tx. Limited data exist on real world effectiveness and costs of nab-P+G v FFX. This study compared median time to tx discontinuation (TTD) and costs between the two cohorts. Methods: A retrospective study was conducted with MedAssets’ de-identified US hospital data. Patients (pts) ≥ 18 yo diagnosed with MPAC between 04/13 and 02/15, completing ≥ 1 cycle of nab-P+G or FFX as 1L, and with ≥ 6 months of data were included. Primary endpoints were median TTD and total costs. Supportive care use and costs were also examined. Between group comparisons used Kaplan-Meier (TTD) and ANOVA (costs). Multivariable general linear regression with gamma distributions were used for costs. Results: A total of 89 pts received nab-P+G, while 61 received FFX. nab-P+G pts were older (age ≥ 70: 31.5% v 11.5%; p < 0.05) compared to FFX, though Charlson Comorbidity Indices were similar (nab-P+G = 8.8, FFX = 9.0). More nab-P+G pts were treated in teaching (56% v 49%) and < 200 bed facilities (27% v 21%), but these differences were not significant. Median TTD did not differ significantly between nab-P+G (120 days) and FFX (98 days; p = 0.77). Median costs per month of tx were lower in nab-P+G pts ($12,192 v $18,743, p < 0.01). More FFX pts used GCSF (66.7% v 22.5%, p < 0.01), while more nab-P+G pts used blood products (BP) (30.0 v 10.4%, p < 0.05). Monthly GCSF and antiemetic costs were lower in nab-P+G pts ($1,584 v $4,793, p < 0.05; $595 v $1,351, p < 0.05). Multivariable analysis confirmed higher total costs (IRR = 1.4, p < 0.01), GCSF costs (IRR = 2.5, p < 0.05) and antiemetic costs (IRR = 6.4, p < 0.01) in FFX pts. No significant differences were seen in BP costs between cohorts. Monthly inpatient costs were lower for nab-P+G ($510 v $3,503, p < 0.01) but not significant (p = 0.18) when controlling for baseline variables. Conclusions: While median TTD was similar between nab-P+G and FFX cohorts, pts treated with FFX had higher total costs driven in part by use of GCSF, antiemetics, and inpatient visits.