免疫疗法中的固定剂量或体重调整剂量?
Marca Diaz-Rangel1, Francisca Sanchez-Rubio2, Andrea Drozdz-Vergara3
1Pharmacy, Hospital General de Albacete, Albacete, Spain marcad@sescam.jccm.es.
European journal of hospital pharmacy : science and practice
|December 18, 2024
概括
固定剂量免疫检查点抑制剂导致严重的药物过量和成本增加. 体重调整剂量提供了实质性的经济节约,并且越来越多地在西班牙医院采用,提高治疗优化.
科学领域:
- 在瘤学瘤学.
- 药物经济学 药物经济学
- 医院 医院 药房 医院药房
背景情况:
- 免疫检查点抑制剂 (ICI) 在癌症治疗中至关重要.
- 目前的固定剂量方案可能导致低于最佳剂量和增加医疗保健支出.
- 在医疗保健机构中存在ICI剂量实践的变化.
研究的目的:
- 分析固定剂量ICI的经济影响.
- 为了确定重量调整剂量的潜在成本节约.
- 描述西班牙医院当前的ICI剂量实践.
主要方法:
- 对297名接受ICI (pembrolizumab,nivolumab,avelumab,durvalumab,cemiplimab) 的患者进行了回顾性多中心观察性研究.
- 分析临床和经济变量,包括药物成本,过量剂量百分比和机会成本.
- 在西班牙医院对ICI剂量方案选择进行匿名调查.
主要成果:
- 确定了固定剂量ICI的重大机会成本:潘布罗利祖马布 (615.316欧元),尼沃卢马布 (486.327欧元).
- 体重调整剂量在54.7%的病例中部分实施,通常由药房和瘤服务部门决定.
- 调查显示,西班牙各医院的ICI剂量方案存在差异.
结论:
- 固定剂量ICI导致药物过量服用和与体重调整剂量相比,对预算产生相当大的影响.
- 通过体重调整剂量的治疗优化提供了潜在的预算节省.
- 西班牙的医疗保健实践显示了ICI剂量的变化,突出了优化需求.
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