早期高效与升级治疗策略在复发性多发性硬化症中的好处,使用治疗顺序模型估计
Ide Smets1, Matthijs Versteegh2, Simone Huygens2
1MS Center ErasMS, Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
概括
多发性硬化症 (MS) 的早期高效治疗 (EHT) 与升级策略具有相似的成本效益,以潜在的更高的成本提供更大的健康益处. 更广泛地使用可负担得起的疗法,如克拉迪宾 (CLA) 和阿勒姆图祖马布 (ALE),可以提高整体的成本效益.
科学领域:
- 卫生经济学 卫生经济学
- 神经学 神经学
- 药物经济学 药物经济学
背景情况:
- 关于预算影响的不确定性阻碍了多发性硬化症 (MS) 的早期高效治疗 (EHT).
- 不同疾病修饰治疗 (DMT) 序列的成本效益对于治疗决策至关重要.
研究的目的:
- 估计升级与多发性硬化症中EHT DMT序列的成本效益.
- 为了比较与不同治疗策略相关的健康益处和成本.
主要方法:
- 用于分析DMT序列的健康经济建模方法.
- 评估健康益处 (减少复发,预防残疾) 和直接/间接的社会成本.
- 场景分析包括先前使用阿勒姆图祖马布 (ALE) 和用克拉迪 (CLA) 重新治疗.
主要成果:
- EHT序列表现出与升级相似的成本效益,以增加成本产生更高的质量调整寿命年 (QALY).
- 早期使用ALE证明更具成本效益,即使副作用的影响增加了十倍.
- 用CLA重复治疗在EHT和升级序列中都是具有成本效益的.
结论:
- 某些EHT序列与升级一样具有成本效益,提供了改善的健康结果,潜在的成本更高.
- 对CLA和ALE的有利成本效益比表明,可以更广泛地应用负担得起的高效疗法.
- 更广泛地使用具有成本效益的DMT可以提高MS管理中EHT和升级方法的经济可行性.
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