在初级晚期或复发性子宫内膜癌治疗中,达拉利马布加化疗的成本效益
Gengwei Huo1,2,3,4, Ying Song5, Wei Liu6,2,3,4
1Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Frontiers in pharmacology
|July 5, 2024
概括
多斯塔利马布加化学疗法对于不匹配修复缺陷 (dMMR) 子宫内膜癌 (EC) 是具有成本效益的. 对于不匹配修复熟练的 (pMMR) EC,成本效益在当前定价下无法实现,但可以通过折扣实现.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 子宫内膜癌 (EC) 是一种严重的妇科恶性瘤.
- 在RUBY试验中,在先进或复发性EC中,多达利利马布加化疗改善了生存率.
- 根据不匹配修复状态 (dMMR/pMMR) 的分层对治疗疗效至关重要.
研究的目的:
- 为了评估德拉利马布加化疗与单独化疗对初级高级或复发性EC的成本效益.
- 从美国付款人的角度分析dMMR和pMMREC子组的成本效益.
- 为了确定相对于支付意愿 (WTP) 门的增量成本效益比率 (ICER).
主要方法:
- 一个马尔科夫模型模拟了患者的治疗途径.
- 计算了经质量调整的寿命年 (QALY) 和终身成本.
- 单变量和概率灵敏度分析评估了模型的稳定性.
主要成果:
- 在dMMR EC中,达利利马布的ICER为每QALY60,349.30美元,表明了成本效益.
- 在pMMR EC中,ICER为每QALY175,788.47美元,超过了WTP的门.
- 在15万美元/QALY门下,Dostarlimab在dMMR EC中显示出100%的成本效益概率,而在pMMR EC中为0.5%.
结论:
- 多斯塔利马布加化学疗法是dMMR晚期或复发性EC的经济有效治疗方法.
- 目前的多达利利马布的成本限制了其在pMMR EC的成本效益.
- 降低duralimab的价格可能会改善它对pMMREC患者的价值主张.
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