健康技術における相対的用量強度と用量遅延因子の利用の見直し 固体腫瘍における腫瘍学薬の評価
Anandaroop Dasgupta1,2, Ankita Kaushik3, Shubhram Pandey4
1Gilead Sciences, Inc., Foster City, CA, USA. Anandaroop.Dasgupta1@gilead.com.
Advances in therapy
|September 4, 2025
まとめ
相対的な用量強度 (RDI) と用量遅延因子 (DDF) の計算は,英国の腫瘍学医療技術評価 (HTA) で大きく異なる. これらの方法の標準化により,がん薬の費用対効果の分析が改善されます.
科学分野:
- 健康経済学
- 腫瘍学
- 医療技術の評価
背景:
- 相対的な用量強度 (RDI) と用量遅延因子 (DDF) は,腫瘍学薬の費用対効果分析に大きく影響し,インクリメンタル費用対効果比 (ICER) に影響を及ぼします.
- RDIとDDFがICERに及ぼす特定の影響と,医療技術評価 (HTA) にわたるその多様な適用に関する公開されたデータは限られている.
研究 の 目的:
- RDI と DDF がどのように計算され,国家保健医療卓越研究所 (NICE) の健康技術評価 (HTA) にどのように適用されるかを分析する.
- RDI/DDFの方法論の違いと,HTAプロセス内のICERへの影響を特定する.
主な方法:
- 開始から2024年3月31日までの固体腫瘍治療のHTAを NICEのウェブサイトで手動で検索する.
- RDI/DDFの計算,経済モデルでの適用,HTAフィードバック,および19の乳がんHTAに焦点を当てた63の関連するHTAからのICERの影響に関するデータ抽出.
主要な成果:
- RDI値は85%から100%の範囲で,HTAにおける計算方法と適用方法の有意な異質性がある.
- NICEの委員会は,RDIの計算の透明性と,投与量変更と浪費に関する仮定に関する懸念を頻繁に指摘した.
- RDIの調整を除くと,通常はICERが5%から10%増加した.
結論:
- イギリスの腫瘍学HTAでは,RDIと投与量変更の処理に相当な差異がある.
- 標準化された方法,より明確なガイドライン,現実世界のデータ,そしてより情報に基づいたHTAの意思決定のための改善されたデータ収集が必要である.
- 正確な費用対効果の評価には,投与量データを経済モデルに統合するための一貫したツールの開発が不可欠です.
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