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在意大利,对先前接受过治疗的患有晚期卵巢癌的患者进行HRD测试的成本效益分析

Carla Rognoni¹, Domenica Lorusso², Francesco Costa³

¹Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Via Sarfatti 10, 20136, Milan, Italy. carla.rognoni@unibocconi.it.

Advances in therapy

|February 8, 2024

概括

前期同源重组缺陷 (HRD) 测试比在意大利进行高级卵巢癌的BRCA测试更具成本效益. 这种策略优化了治疗,并改善了患者的治疗结果,包括预期寿命和生活质量.

科学领域:

在瘤学瘤学.
卫生经济学卫生经济学
遗传学遗传学是一个

背景情况:

卵巢癌 (OC) 影响着众多女性,同源重组缺陷 (HRD) 在约50%的病例中存在,这表明了聚ADP-ribose聚合酶 (PARP) 抑制剂的潜在疗效.
由于BRCA检测只能在25%的患者中发现突变,因此对治疗决策的指导不那么全面.

研究的目的:

评估前期同源重组缺陷 (HRD) 测试与意大利高级卵巢癌的BRCA测试的成本效益.
根据基因检测结果,优化治疗管理,包括使用PARP抑制剂.

主要方法:

以意大利国家医疗保健服务 (NHS) 的角度考虑,开发了一个具有终身视野的成本效益分区生存模型.
该模型比较了HRD测试,BRCA测试和顺序测试方法 (BRCA跟随HRD用于BRCA阴性病例).
为了确保模型的稳定性,进行了确定性和概率灵敏度分析,采用3%的折扣率.

主要成果:

同类重组缺陷 (HRD) 测试与BRCA测试相比,证明了成本效益,增量成本效益比为22,610欧元/QALY.
与连续测试相比,HRD测试也是一个节省成本的策略.
概率灵敏度分析表明,在50,000欧元/QALY的支付意愿门下,在98.5%的模拟中,HRD测试具有成本效益.

结论:

在晚期卵巢癌中识别遗传异常是资源密集的.
与BRCA测试相比,前期HRD测试提供了具有成本效益的配置,提高了医疗保健资源的有效分配.
这种方法可以改善晚期卵巢癌患者的预期寿命和生活质量.

关键词:

在BRCA测试中,我们进行了BRCA测试.人力资源发展委员会 (HRD) 测试卵巢癌是发生在卵巢中的癌症.在 PARP 抑制剂.

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