对耐火性转移性结肠直肠癌的regorafenib剂量优化的成本效益分析
Tanios Bekaii-Saab1, Sang Kyu Cho2, Brian Hocum3
1Mayo Clinic Comprehensive Cancer Center, Phoenix, AZ, USA.
Journal of medical economics
|April 23, 2025
概括
在转移性结直肠癌 (mCRC) 治疗中,雷戈拉费尼布剂量优化 (ReDO) 与三里丁/提皮拉和贝瓦西祖马布 (TAS-BEV) 相比,具有成本效益,并且在果丁尼布上占主导地位. 对于美国付款人来说,ReDO提供了有利的成本效益概况.
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:
- 新兴的转移性结直肠癌 (mCRC) 的第三线或后期疗法包括调节剂量优化 (ReDO),trifluridine/tipiracil和bevacizumab (TAS-BEV) 组合以及fruquintinib.
- 对医疗保健支付者来说,评估这些新型mCRC治疗的相对成本效益至关重要.
研究的目的:
- 从美国付款人的角度评估ReDO,TAS-BEV和fruquintinib对mCRC的成本效益.
- 通过分区生存模型和质量调整寿命年 (QALYs) 来比较这些疗法.
主要方法:
- 开发了一个分区生存模型 (PSM) 来估计成本和QALYs.
- 计算了增量成本效益比率 (ICER),并通过敏感性和场景分析检查了稳定性.
- 分析包括具有相同疗效的场景,先前的抗血管内皮生长因子 (VEGF) 治疗,以及fruquintinib的替代临床投入.
主要成果:
- 与TAS-BEV相比,ReDO在美国支付意愿 (WTP) 门 (15万美元/QALY) 时具有成本效益.
- TAS-BEV的QALY比ReDO更高,但在高ICER (554,567美元/QALY) 的情况下.
- 在Fruquintinib (更高的QALY,更低的成本) 上,ReDO占主导地位.
- 在之前接受过抗VEGF治疗的患者中,ReDO仍然具有成本效益.
结论:
- 从美国付款人的角度来看,对Regorafenib剂量优化 (ReDO) 是第三线或更晚的mCRC治疗的成本有效策略.
- 尽管TAS-BEV的QALY收益更高,但ReDO的成本效益更高.
- 与fruquintinib相比,ReDO提供了一个占主导地位的成本效益优势.
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