型DX乳腺复发得分的成本效益分析从美国社会视角的测试
Vladislav Berdunov1, Gebra Cuyun Carter2, Ewan Laws1
1Putnam, London, UK.
ClinicoEconomics and outcomes research : CEOR
|June 10, 2024
概括
瘤型DX乳腺复发评分测试是指导早期乳腺癌化疗决策的成本效益. 与传统的风险评估相比,它可以改善结果并降低成本.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 21基因测定 (瘤型DX) 评估HR+/HER2-早期乳腺癌的远程复发风险.
- 辅助化疗决策对于优化患者的治疗结果至关重要.
研究的目的:
- 评估21基因测定与标准临床病理风险工具的成本效益.
- 在HR+/HER2-早期乳腺癌中为辅助化疗决策提供信息.
主要方法:
- 使用了结合决策树和马尔科夫元件的经济模型.
- 来自TAILORx (N0) 和RxPONDER (N1) 试验的数据为患者分层和复发概率提供了信息.
- 该模型从医疗保健支付者和社会角度评估了成本和结果.
主要成果:
- 与单独临床病理风险相比,瘤型DX测试以较低的成本产生了更多的质量调整寿命年 (QALYs).
- 社会视角分析显示了显著的成本节约 (N0:-13,395美元;N1:-2526美元) 和QALY收益 (N0:0.25;N1:0.08).
- 避免远程复发和化疗成本是关键的成本驱动因素;生产力下降对社会成本产生了重大影响.
结论:
- 在辅助化疗决策中使用复发率 (RS) 提高了终身年益并降低了医疗保健成本.
- 与仅依赖HR+/HER2-早期乳腺癌的临床病理风险因素相比,21基因测定是一种主要的策略.
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