特拉斯图祖马布德鲁克斯坦的成本效益对于先前治疗的低HER2水平的晚期乳腺癌
Demin Shi1, Xueyan Liang2, Yan Li2
1Department of Reproductive Medicine, The People's Hospital of Hechi, Hechi, Guangxi, People's Republic of China.
PloS one
|August 24, 2023
概括
与化疗相比,Trastuzumab deruxtecan (T-DXd) 是治疗 HER2 低水平晚期乳腺癌 (BC) 的一个具有成本效益的治疗方法. 在100,000美元/QALY门,T-DXd显示出显著的成本效益,支持其在患者护理中的价值.
科学领域:
- 在瘤学瘤学.
- 药物经济学 药物经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 特拉斯图祖马布德鲁克斯泰干 (T-DXd) 显示在先前治疗的HER2低水平的晚期乳腺癌 (BC) 中具有临床疗效.
- 由于T-DXd的高成本,需要对标准化疗进行彻底的成本效益评估.
- 了解T-DXd的经济价值对于医疗保健决策至关重要.
研究的目的:
- 评估T-DXd与化学疗法相比的成本效益,用于先前接受治疗的HER2-低高级乳腺癌患者.
- 为了确定增量成本效益比率 (ICER) 和净健康益处.
- 评估降价和支付意愿门对T-DXd成本效益的影响.
主要方法:
- 使用了三个健康状态的分区生存模型.
- 来自DESTINY-Breast04试验的患者数据为模型参数提供了信息.
- 进行了概率和单向灵敏度分析,以及子组分析,以评估模型的稳定性.
主要成果:
- 对于T-DXd与化疗的ICERs在不同的HER2表达水平中从82,808美元/QALY到93,358美元/QALY不等.
- 敏感性分析确定了PFS/OS的T-DXd成本和危险比率作为关键驱动因素.
- 在100,000美元/QALY支付意愿值时,T-DXd显示81.10%的概率对所有HER2-低高级BC患者具有成本效益.
结论:
- 在美国,T-DXd代表了先前接受治疗的HER2-低高级乳腺癌患者的经济有效的治疗选择.
- 药物的成本效益在100,000美元/QALY的支付意愿门上得到证实.
- 进一步的价格调整可以提高T-DXd在较低的支付意愿门的成本效益.
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