Pancreatic cancer is a disease with a very poor prognosis and incurs large medical and
economic costs in a short course of disease. According to data from Cancer registration
Statistics Program released in 2020, 243,837 new cancers occurred in Korea in 2018, of
which pancreatic cancer (C25) was ranked 8th with 7,611 cases, 3.1% of total cancer
incidences. The crude incidence rate was 14.8 cases/100,000 (https://www.cancer.go.kr/).
According to a 2002 report, Korean pancreatic cancer patient's per capita medical
expenses and income loss totaled 93 million won, showing the largest economic loss among
cancers.
Pancreatic cancer is known to have a 5-year survival rate of around 10% worldwide, and it
is thought that the survival rate is gradually increasing after the introduction of
FOLFIRINOX, and albumin-bound paclitaxel (GnP). Since the measures to strengthen the
coverage of severe diseases in 2005, the coverage of severe diseases has also been
strengthened. Since 2016, with the reimbursement of the use of FOLFIRINOX and GnP, one of
these two regimens has been the first-line chemotherapy in most pancreatic cancer
patients who are eligible for chemotherapy in Korea. In addition, these two regimens can
be administered in the first and second alternations of each other. Recently, after the
first gemcitabine-based treatment for metastatic pancreatic cancer, the second-line
treatment with 5-FU and folinic acid with liposomal irinotecan demonstrated significant
increased survival rates compared with 5FU/LV in a randomized Phase 3 Trial (NAPOLI-1).
Since the introduction of the aforementioned chemotherapy, the change in survival rate is
not yet well known, and real-world data on the cost and cost-effectiveness of pancreatic
cancer treatment are still lacking in Korea. In the United States, in 2012, research
results on the cost and trend analysis of pancreatic cancer treatment were published, and
in that paper, the treatment cost for pancreatic cancer was a high economic burden,
especially in the elderly, and targeted therapy or screening tests are required to reduce
future treatment costs. A recent study reported by Investigator research group showed
that FOLFIRINOX and GnP have similar efficacy and comparable toxicity in patients with
metastatic pancreatic cancer using Korean Pancreatic Cancer (K-PaC) registry. In
particular, patients who could receive second-line chemotherapy survived for about 17
months in the K-PaC registry. The K-PaC results provided the actual results of pancreatic
cancer treatment in Korea relatively well, but the data has disadvantages that do not
represent all pancreatic cancer patients in Korea, and cost analysis was not performed.
Therefore, it is necessary to evaluate the change in survival rate and costs with the
advent of the aforementioned chemotherapy by analyzing big data representing the whole
pancreatic cancer patients in Korea.