瘤学临床途径利用与转移性固体瘤患者中毒性和成本结果之间的关联
Ying Liu1, Samyukta Mullangi2, David Debono1
1Elevance Health, Inc, Indianapolis, IN.
JCO oncology practice
|June 29, 2023
概括
在途径癌症护理方案显著降低了转移性癌症患者的成本. 虽然毒性因癌症类型而异,但与治疗相关的整体住院和与免疫相关的不良事件 (IRAE) 在路径内外的组之间是相似的.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 临床药房 临床药房
背景情况:
- 转移性癌症的治疗通常涉及复杂的疗法,成本和毒性各不相同.
- 临床途径旨在标准化护理,潜在地改善结果并降低费用.
- 评估在线路与非线路方案的实际有效性和经济影响至关重要.
研究的目的:
- 为了比较转移性癌症患者的毒性和成本结果,这些患者接受在途径和离路径的第一线抗癌疗法.
- 分析急诊室访问,住院,支持性护理使用,免疫相关不良事件 (IRAE) 和整体医疗保健成本的差异.
主要方法:
- 使用国家保险索赔和授权数据的回顾性观察研究 (2018年1月-2021年10月).
- 包括9种转移性癌症 (乳腺,肺,结肠直肠,胰腺,黑色素瘤,脏,膀,胃,子宫) 的成年人.
- 多变量回归分析了毒性和成本结果,比较了路径内和路径外的治疗组.
主要成果:
- 在途径方案与显著的成本节约有关:总医疗费用减少了17,589美元,每名患者的化疗费用减少了22,543美元.
- 毒性结果显示出差异性:与治疗相关的住院治疗和IRAE总体相似,但更多的全因住院治疗黑色素瘤在途径上.
- 支持性护理药物使用因癌症类型而异,在膀和结肠直肠癌中使用率较高,在乳腺和肺癌中使用率较低.
结论:
- 在途径疗法在转移性癌症护理中显示出巨大的成本节约潜力.
- 在线和非线路治疗之间,毒性概况在很大程度上是可比的,尽管存在疾病特异性的变化.
- 有证据支持采用临床途径方案,以优化护理并减少转移性癌症患者的财务负担.
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