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针对晚期,转移性和复发性宫癌的顺序向治疗:对患者旅程的成本效益分析

Michael T Richardson¹, Kristopher Attwood², Gabriella Smith³

¹University of California, Los Angeles, CA, USA.

Cancer control : journal of the Moffitt Cancer Center

|August 30, 2023

概括

针对宫癌的向疗法测序提高了生存率,但增加了成本. 免疫疗法和生物药物的组合为转移和复发病例提供了更好的结果,尽管药物费用更高.

科学领域:

在瘤学瘤学.
药物经济学药物经济学
临床试验分析

背景情况:

转移性和复发性子宫癌存在重大治疗挑战.
当前的治疗模式随着向疗法和免疫疗法的出现而不断发展.
评估新型治疗序列的成本效益对于临床决策至关重要.

研究的目的:

评估转移性和复发性宫癌中不同向治疗序列的结果和成本效益.
为了比较各种药物组合的疗效和经济影响.

主要方法:

模拟模型是使用关键的II期和III期临床试验的数据来开发的:GOG-240 (贝瓦西祖马布),GOG 3016 (西米普利马布),KEYNOTE-826 (佩姆布利祖马布) 和GOG 3023 (提索图马布维多丁).
评估的治疗顺序包括化疗加贝瓦西祖马布,然后是化疗,塞米普利马布或提索托马布维多丁,以及化疗加贝瓦西祖马布和潘布罗利祖马布,然后是化疗或提索托马布维多丁.
成本数据来源于IBM Micromedex RED BOOKTM和制造商报告的成本.

主要成果:

序列化疗 + 贝瓦西祖马布 → 化疗产生了21.8个月的平均整体存活期 (mOS),成本效益比 (CER) 为119,835.79.79美元.
化疗 + 贝瓦西祖马布 → 塞米普利马布导致mOS为28.5个月,CER为162,039.16美元.
最先进的序列,化疗 + 贝瓦齐祖马布 + 布罗利祖马布 → 化疗和化疗 + 贝瓦齐祖马布 + 布罗利祖马布 → 蒂索托马布维多丁,分别显示mOS为32.9和36.5个月,CER值高于249,930.10美元和320,072.99美元.

结论:

免疫疗法和生物药物的组合显著提高了宫癌患者的整体存活率.
这些先进的治疗策略与总体成本大幅增加有关,主要是由于药物采购费用.
优化向治疗序列需要平衡改善的生存效益与经济考虑.

关键词:

宫癌:子宫癌是一种癌症.经济效益性经济效益性免疫疗法免疫疗法新型疗法新型疗法顺序性治疗是指连续的治疗.

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