针对复发性或转移性鼻癌的第一线免疫疗法组合:更新的网络元分析和成本效益分析
Jiaqi Han1,2,3, Ni Zeng1,2,3, Kun Tian4,5
1Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Head & neck
|July 12, 2023
概括
第一线化疗免疫疗法显著改善了复发性或转移性鼻癌 (R/M-NPC) 的存活率. 在这些先进的治疗方法中,托里帕利马布加化疗 (TOGP) 是最具成本效益的选择.
科学领域:
- 在瘤学瘤学.
- 药物经济学 药物经济学
- 卫生技术评估 卫生技术评估
背景情况:
- 复发性或转移性鼻癌 (R/M-NPC) 的一线治疗已经在免疫疗法组合方面取得了进展.
- 随机临床试验 (RCT) 证实,托利帕利马布,卡梅利祖马布和提塞利祖马布加化学疗法 (TOGP,CAGP,TIGP) 与安慰剂加化学疗法 (PLGP) 的生存率有所改善.
- 高昂的免疫疗法成本给患者和医疗保健系统带来了巨大的财务负担.
研究的目的:
- 评估R/M-NPC的第一线免疫疗法组合的成本效益.
- 为了比较TOGP,CAGP,TIGP和PLGP的生存效益和成本.
- 从中国付款人的角度确定最具成本效益的治疗策略.
主要方法:
- 对3项涉及815名患者的RCT进行了贝叶斯网络元分析 (NMA).
- 总生存 (OS) 和无进展生存 (PFS) 危险比率 (HRs) 是主要结局.
- 一个马尔科夫模型评估了成本效益,计算增量成本效益比率 (ICUR) 和执行灵敏度分析.
主要成果:
- 与PLGP相比,化学免疫疗法 (TOGP,CAGP,TIGP) 显示PFS和OS显著更长.
- 对TOGP,CAGP和TIGP的额外成本为48,339美元,22,900美元和23,162美元,分别为1.89美元,0.73美元和0.960美元的额外QALY.
- 针对TOGP的ICURs为25,576美元/QALY,针对CAGP为31,370美元/QALY,针对TIGP为31,729美元/QALY,在免疫疗法组中,TOGP是最具成本效益的.
结论:
- 第一线免疫疗法组合在中国的R/M-NPC患者中比单独化疗提供了显著的生存和成本效益优势.
- 在评估的化学免疫疗法方案中,托里帕利马布加化疗 (TOGP) 成为最具成本效益的选择.
- 这些发现支持免疫疗法组合在38,029美元/QALY的支付意愿门内的价值.
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