自主干细胞移植和可移植多发性骨髓瘤患者的维持疗法:基于网络元分析的成本效益分析
Weijia Wu1, Yannan Wang2, Yingting Lou1
1Department of Science and Education of the Fourth Affiliated Hospital, and Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
Expert review of pharmacoeconomics & outcomes research
|February 4, 2025
概括
自主干细胞移植 (ASCT) 与二年达拉图穆巴维护是中国新诊断的多发性骨髓瘤最具成本效益的策略. 这种方法与其他维持疗法和非ASCT选择相比,具有更高的价值.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 多发性骨髓瘤是一种血液性恶性瘤,需要有效的治疗策略.
- 移植资格的患者可以从自身干细胞移植 (ASCT) 中受益.
- 在ASCT后的维持治疗对长期结果至关重要.
研究的目的:
- 评估ASCT与中国新诊断多发性骨髓瘤的各种维持疗法相结合的成本效益.
- 将不同的ASCT和维护策略与非ASCT方法进行比较.
主要方法:
- 使用决策树和马尔科夫模型进行终身成本效益分析.
- 评估了经质量调整的寿命年数 (QALY) 和医疗保健成本.
- 实用值是从已发表的文献中得出的;成本是从回顾性分析和国家药物数据中得出的.
主要成果:
- 与达拉图穆马布维持两年的ASCT产生了最低的折扣成本 (1,394,183 CNY).
- 与没有ASCT与连续的lenalidomide维护相比,使用一年的lenalidomide维护的ASCT提供了更多的QALY,成本更低.
- 随着ASCT进行一年的莱纳利多米德维护,比不进行维护更具成本效益.
结论:
- 在中国的支付意愿 (WTP) 门内,ASCT策略,特别是一到两年的维持疗法,具有成本效益.
- 随着两年的达拉图穆马布维护后的ASCT成为最具成本效益的选择.
- 在ASCT后一年的lenalidomide维护比没有维护或连续的lenalidomide治疗提供了更高的价值.
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