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晚期胆道癌患者的免疫检查点抑制剂:成本效益分析

Youwen Zhu¹, Kun Liu¹, Hong Zhu^1,2

¹Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.

Liver international : official journal of the International Association for the Study of the Liver

|August 18, 2023

概括

在中国,一线杜尔瓦卢马布加上凝和 (GemCis) 对晚期胆道癌 (aBTC) 具有成本效益,但在美国并非如此. 这一经济评估比较了durvalumab与pembrolizumab加上GemCis用于aBTC治疗.

科学领域:

在瘤学瘤学.
卫生经济学卫生经济学
药物经济学药物经济学

背景情况:

免疫检查点抑制剂 (ICI) 为晚期胆道癌 (aBTC) 提供了新的治疗选择.
经济评估对于指导aBTC治疗选择至关重要.
这项研究比较了第一线杜尔瓦卢马布或布罗利祖马布加GemCis对aBTC的成本效益.

研究的目的:

为了比较一线杜尔瓦卢马布加GemCis与布罗利祖马布加GemCis治疗晚期胆道癌症 (aBTC) 的成本效益.
从美国和中国医疗保健系统的角度分析治疗成本和结果.

主要方法:

基于TOPAZ-1和KEYNOTE-966试验,开发了一种具有15年视野和三个健康状态的马尔科夫模型.
增量成本效益比率 (ICER) 用美国和中国的支付意愿 (WTP) 门来计算.
进行了敏感性和子组分析,以确保研究结果的可靠性.

主要成果:

与美国和中国的pembrolizumab加GemCis相比,Durvalumab加GemCis增加了成本和经质量调整的寿命年 (QALYs).
杜尔瓦卢马布加GemCis的ICER在美国为288,725美元/QALY,在中国为26,401美元/QALY.
确定ICI的成本是影响结果的主要因素.

结论:

第一线杜尔瓦卢马布加GemCis是中国aBTC患者的经济有效的选择.
然而,这种治疗策略在美国的aBTC患者中并没有被发现具有成本效益.
该研究强调了医疗保健系统背景在癌症治疗的经济评估中的重要性.

关键词:

在 Durvalumab 中使用.这就是Pembrolizumab.先进的胆道癌症是胆道癌症.吉姆西塔和西斯普拉丁的使用.增量性成本效益比率是一个增量性成本效益比率.

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