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治疗EGFR突变高级或转移性非小细胞肺癌患者的医疗资源使用,医疗费用和未满足的需求

David Waterhouse¹, Iris Li², Laura Morrison³

¹OHC (Oncology-Hematology Care), Cincinnati, Ohio.

Journal of health economics and outcomes research

|September 2, 2025

概括

对于具有EGFR突变 (Ex19del/ L858R) 的晚期非小细胞肺癌 (NSCLC),每次后续治疗 (LOT) 时间都更短,成本也更高. 优先考虑有效的第一线治疗对于管理疾病进展和医疗保健成本至关重要.

科学领域:

癌症学
健康经济学
药物经济学

背景情况:

大约17%的非小细胞肺癌 (NSCLC) 病例含有EGFR突变 (EGFRm),主要是19号外基因缺失 (Ex19del) 或21号外基因替代 (L858R).
对于患有EGFRm (Ex19del/ L858R) 晚期NSCLC的患者,他们需要用氨酸激酶抑制剂 (TKIs) 治疗,包括奥西默蒂尼布,这影响了美国人口的健康决策.

研究的目的:

描述EGFRm (Ex19del/ L858R) 晚期NSCLC开始第一线治疗的患者的医疗资源利用率 (HRU) 和相关费用.
分析1L,二线 (2L) 和三线 (3L) 治疗的HRU和成本.

主要方法:

利用IBM MarketScan®研究数据库 (2010年1月至2023年1月) 来识别在2018年4月18日或之后启动EGFR-TKI的晚期NSCLC的成年患者.
每个患者每月 (PPPM) 描述所有原因的HRU和1L,2L和3L的成本.
在没有免疫治疗的情况下接受1L osimertinib单疗或基于的化疗 (PBC) 的分析子组.

主要成果:

这项研究包括409名患者,72. 9%的患者开始接受1L的奥西默蒂尼布治疗.
平均LOT持续时间随着每一条连续线下降 (1L: 10.2个月; 2L: 8.7个月; 3L: 8.0个月).
整个 LOT 的平均PPPM成本从1L的27,751美元上升到3L的31,251美元. 1L osimertinib单一治疗小组的费用为27610美元 (1L),35501美元 (2L) 和36618美元 (3L).

结论:

对于EGFRm (Ex19del/L858R) 晚期NSCLC的每次LOT都与更短的持续时间和更高的成本有关.
这些发现强调了利用有效的1L治疗方法延缓疾病进展并减少整体HRU和医疗保健支出的重要性.

关键词:

晚期非小细胞肺癌表皮生长因子受体突变医疗费用医疗保健资源的使用奥西默蒂尼布基于的化疗氨酸激酶抑制剂

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