口腔向癌症药物之间的关联 净健康益处,吸收和支出
Kelsey S Lau-Min1, Yaxin Wu2, Shavon Rochester3
1Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
具有较高净健康益 (NHB) 评分的向性癌症药物 (TCD) 更频繁地被处方. 虽然口服TCD的总支出很高,但患者的自付费用很小.
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:
- 向性癌症药物 (TCD) 在癌症治疗中提供了显著的进步,但在临床有效性和患者财务负担方面表现出差异.
- 美国临床瘤学会 (ASCO) 价值框架提供了一种方法来量化癌症药物的健康净益 (NHB),考虑生存,毒性和症状缓解.
研究的目的:
- 评估口服向性癌症药物 (TCD) 的净健康益处 (NHB) 评分与其临床吸收及其相关医疗保健支出之间的关联.
- 分析患者自费 (OOP) 费用与基于其NHB的口服TCD的总支出.
- 确定NHB是否影响口服TCD的处方模式和经济影响.
主要方法:
- 一项回顾性队列研究分析了2012-2020年间18-64岁患者的非识别商业索赔数据,这些患者有发生性口服TCD索赔.
- 口服TCD被分为低 (<40),中等 (40-60),高 (>60) 的NHB得分类别.
- 采用了通用线性模型来评估TCD NHB与支出之间的关系,并根据癌症类型进行调整.
主要成果:
- 这项研究包括8524名患者,涉及8种口服TCD,用于9种先进黑色素瘤,乳腺,肺癌和胰腺癌的第一线指示.
- 中等和高NHB的TCD构成了大多数处方,这表明人们更喜欢具有更高评估价值的药物.
- 患者的中位数自付费 (OOP) 支出很低 (28天18.78美元),其中45%的患者没有OOP费用,而中位数总支出达到每28天供应10,118.79美元.
- 在NHB得分和总支出之间发现了显著的积极关联,每增加10个点的NHB与总支出额外的1083.56美元相关.
结论:
- 与具有中高NHB分数的药物相比,具有较低NHB分数的口服TCD的处方频率较低.
- 对口服TCD的医疗保健总支出相当大,并且与药物的健康净益相关.
- 商业保险患者在很大程度上受到与口服TCD相关的大量自付费用的保护.
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