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对不可切除的肝细胞癌有前途的第一线免疫组合疗法:成本效益分析

Feng Wen^1,2, Peng Huang³, Qiuji Wu³

¹Division of Abdominal Tumor Multimodality Treatment, Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

Cancer medicine

|August 16, 2024

概括

卡姆雷利祖马布加上利沃赛拉尼布是对不可切除的肝细胞癌 (HCC) 最具成本效益的第一线治疗方法. 与其他免疫组合相比,这种组合为中国医疗保健支付人提供了显著的价值.

科学领域:

在瘤学瘤学.
卫生经济学卫生经济学
药物经济学药物经济学

背景情况:

肝细胞癌 (HCC) 对全球的健康和经济构成重大挑战,特别是在中国.
一线免疫组合疗法已经成为对不可切除的HCC的有希望的治疗方法.
这些组合的成本效益仍然是医疗保健系统的一个重要考虑因素.

研究的目的:

评估各种一线免疫组合疗法对不可切除的HCC的成本效益.
从中国付款人的角度来看,确定最实惠和最有价值的治疗策略.

主要方法:

一个马尔科夫模型是基于五个主要的III期随机试验的数据开发的.
该模型评估了五种免疫组合的成本效益:STRIDE,阿特佐利祖马布 + 贝瓦西祖马布,辛蒂利马布 + 贝瓦西祖马布生物类似剂,卡梅利祖马布 + 里沃塞拉尼布和潘布罗利祖马布 + 伦瓦提尼布.
计算了成本效益比率 (CER) 和增量成本效益比率 (ICER),并进行了敏感性分析以确保稳定性.

主要成果:

卡姆雷利祖马布 + 里沃塞拉尼布 (C+R) 成为最具成本效益的策略,每QALY的CER为13,306.89美元.
辛提利马布+贝瓦西祖马布生物类似剂 (S+B) 是第二个最具成本效益的选择,每QALY为24,072.86美元.
与C+R相比,S+B的ICER为每QALY70,725.38美元,如果支付意愿值超过73,500美元/QALY,则成为主导.

结论:

卡姆雷利祖马布加上利沃赛拉尼布是中国不可切割的HCC的高性价比的第一线治疗选择.
这一发现支持将C+R整合到临床实践中,以优化资源配置.
建议进行进一步的现实研究,以验证这些药物经济学发现.

关键词:

经济效益性成本效益性一线的全身治疗.免疫组合疗法是一种免疫组合疗法.不能切除的肝细胞癌.

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