OBJECTIVES: Metastatic pancreatic cancer (mPC) is a leading cause of cancer-related deaths and morbidity worldwide. Objectives of this systematic literature review include identifying healthcare resource utilization (HCRU) and costs associated with mPC.

METHODS: Studies of economic burden associated with mPC were identified from searches of MEDLINE® and Embase® databases (2008–2019), relevant cancer registries, and conference abstracts (2015–2019).

RESULTS: Nineteen studies reporting costs of mPC management and 13 HCRU studies were included in the final analysis. mPC was associated with high hospitalization rates (84.1%) and emergency department visits (73.3%). In the US, inpatient stays were the highest contributor (57.8%) to the total cost of first-line mPC treatment. In one study, total overall monthly costs (US$) for mPC (across all therapy lines) ranged between $9,478–$12,042 (cost years: 2008–2012), most of which was due to inpatient, outpatient, and office visits.

Administration costs for nab-paclitaxel+gemcitabine (nab-P/GEM) and folinic acid+fluorouracil+irinotecan+oxaliplatin (FOLFIRINOX) ranged between $900–$1,900 and $1,200–$3,010, respectively.

nab-P/GEM and FOLFIRINOX for mPC were associated with substantial HCRU, including high rates of supportive care utilization (87.4% and 95.3% of patients undergoing first-line nab-P/GEM and FOLFIRINOX, respectively); supportive care costs ranged between $1,600–$3,000 and $4,500–$8,800, respectively (cost years: 2011–2015). Total monthly per-patient costs for first-line nab-P/GEM and FOLFIRINOX ranged from $16,600–$23,600 and $17,700–$26,600, respectively (cost years: 2011–2015). Chemotherapy use among patients aged ≥66 years with mPC was associated with substantially increased HCRU and higher patient out-of-pocket costs near death, as well as a higher median Medicare payment versus no chemotherapy ($17,959 vs $14,032; cost years: 2006–2011).

CONCLUSIONS: mPC and mPC treatments are associated with frequent hospitalizations and emergency room visits. Furthermore, nab-P/GEM and FOLFIRINOX were associated with high administration and supportive care costs.