在高度活跃的复发性复发性多发性硬化症中早期与延迟使用natalizumab的成本后果分析:一个模拟研究研究
Hernan Inojosa1, Dirk Schriefer1, Nils-Henning Ness2
1Department of Neurology, Center of Clinical Neuroscience, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Journal of neurology
|January 17, 2025
概括
在多发性硬化症 (MS) 早期开始使用纳塔利祖马布 (NAT) 改善了临床结果和就业,同时降低了与延迟治疗相比的社会成本. 早期启动NAT提供了长期的经济效益.
科学领域:
- 药物经济学 药物经济学
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 纳塔利祖马布 (NAT) 是一种高活性多发性硬化症 (MS) 的有效疾病修饰疗法 (DMT).
- 复杂的决策往往会导致最初使用效率较低的疗法.
- 生物类似NAT的可用性允许竞争性定价,影响治疗策略.
研究的目的:
- 评估在多发性硬化症 (MS) 治疗中启动纳塔利祖马布 (NAT) 的社会影响.
- 通过成本后果分析,比较不同的NAT启动场景 (连续,早期切换,延迟切换).
主要方法:
- 采用了使用11个健康状态的扩展残疾状态量表 (EDSS) 的10年马尔科夫模型.
- 纳塔利祖马布与常见的初始DMT (格拉蒂拉默酸盐,特里弗卢诺米德,二甲基烟酸盐,芬戈利莫德) 进行了比较.
- 场景包括连续使用NAT,在一年后切换到NAT,并在5年后切换.
主要成果:
- 持续使用NAT最大限度地提高了在EDSS较低水平的时间,减少了复发,并在10年内提高了就业率.
- 一年后切换到NAT显示了与连续使用NAT相比的结果.
- 尽管最初的DMT成本较高,但持续和早期使用NAT导致整体疾病管理成本降低,包括间接和非DMT医疗成本.
结论:
- 在多发性硬化症 (MS) 中持续和早期启动纳塔利祖马布 (NAT) 产生了优异的临床结果.
- 与延迟启动相比,早期使用NAT显著降低了整体社会经济负担.
- 这些发现表明,如果提前采用NAT,可能会节省大量的长期成本.
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