在激素受体阳性晚期乳腺癌患者中添加capivasertib与fulvestrant:一个成本效益分析
Yitian Lang1, Qingqing Chai1, Yan Lin1
1Department of Pharmacy, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
在美国,Capivasertib加Fulvestrant对晚期乳腺癌的治疗不具有成本效益. 这种新型的泛-AKT抑制剂治疗,虽然显示出抗瘤活性,但超过了医疗保健支付者的典型成本效益值.
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:
- 新型泛AKT抑制剂Capivasertib在激素受体阳性晚期乳腺癌中表现出抗瘤活性.
- 对于这种患者群体,与富勒韦斯特兰 (fulvestrant) 结合的卡维萨塞蒂布的成本效益仍然未确定.
- 评估治疗价值对于医疗保健支付人的决策至关重要.
研究的目的:
- 评估capivasertib加富勒弗兰特与富勒弗兰特单独治疗晚期乳腺癌的成本效益.
- 从美国医疗保健支付人的角度提供经济见解.
- 从中国的角度进行实验分析,并提出具体的假设.
主要方法:
- 使用分区生存模型来模拟乳腺癌的进展.
- 来自CAPItello-291试验的整体生存 (OS) 和无进展生存 (PFS) 数据被推断.
- 计算了增量成本效益比 (ICUR),并进行了敏感性分析 (OWSA,PSA).
主要成果:
- 在美国,capivasertib加fulvestrant的基础病例ICUR估计为709,647美元/质量调整寿命年 (QALY).
- 敏感性分析表明,OS危险比率和capivasertib成本显著影响了结果.
- 概率灵敏度分析显示,美国的组合治疗的成本效益概率为0%.
结论:
- 对于HR阳性晚期乳腺癌,Capivasertib加富勒韦斯特兰在美国目前的价格下不太可能是与富勒韦斯特兰单独治疗相比,具有成本效益的治疗选择.
- 从中国的角度来看,实验分析也表明这种疗法缺乏成本效益.
- 可能需要进一步的经济评估来确定最佳的定价或基于价值的策略.
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