用新药治疗多发性骨髓瘤第一/第二次复发患者的组合疗法的成本效益分析:马尔科夫模型方法与校准技术

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Weijia Wu¹, Fengyuan Tang¹, Yannan Wang²

¹Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.

Health economics review

|March 15, 2025

概括

这项研究评估了中国复发性多发性骨髓瘤 (MM) 多种组合疗法的成本效益. 新型药物组合疗法带来了巨大的财务负担,尽管有生存益处,但挑战了它们的经济价值.

科学领域:

药物经济学药物经济学
在瘤学瘤学.
卫生经济学卫生经济学

背景情况:

越来越多的证据支持用于先前治疗多发性骨髓瘤 (MM) 的组合疗法.
经济评估对于在医疗保健系统中确定成本有效的治疗方法至关重要.
本研究的重点是中国的第一/第二次复发MM患者.

研究的目的:

评估各种组合疗法对第一/第二复发多发性骨髓瘤 (MM) 的成本效益.
为中国医疗保健系统提供有关MM治疗选择的经济视角.

主要方法:

马尔科夫模型被用来评估三个主要药物组:博尔特佐米布,莱纳利多米德和卡菲尔佐米布.
结合了随机临床试验 (RCT) 的临床数据和来自江省竞标数据库的成本数据.
实用值是通过中国EuroQoL五维五级问卷收集的,并进行了灵敏度分析.

主要成果:

在博特佐米布组中,波马利多米德-博特佐米布-甲在支付意愿 (WTP) 门内是最具成本效益的疗法.
列纳利多米德和卡菲尔佐米布组中的几种组合疗法超过了WTP值,这表明相对于益处的成本较高.
敏感性分析证实了基准案例发现的稳定性.

结论:

新型药物组合疗法对复发性MM的实质性成本对其经济合理性提出了挑战.
进一步的研究应该考虑治疗方案的异质性,以充分评估经济价值.
医疗保健系统对MM治疗决策的成本效益仍然是一个关键因素.

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