贝瓦西祖马布治疗染色体不稳定的转移性结直肠癌:德国,爱尔兰和西班牙新型精确治疗方法的成本效益分析
Jonathan Briody1, Ian S Miller2, James F O'Mahony3,4
1Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Beaux Lane House, Lower Mercer St, Dublin 2, Ireland. jonathanbriody@rcsi.ie.
PharmacoEconomics
|February 4, 2026
概括
在转移性结直肠癌 (mCRC) 的第一线化疗中添加贝瓦西祖马布是不具有成本效益的,即使对于可能有更好的反应的染色体不稳定性 (CIN) 患者也是如此. 这一发现适用于德国,爱尔兰和西班牙,无论医疗费用或补偿政策如何.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 翻译研究是翻译研究.
背景情况:
- 贝瓦西祖马布 (阿瓦斯) 已被批准用于转移性结肠直肠癌 (mCRC),但由于适度的反应率,成本效益往往失败.
- ANGIOPREDICT联盟确定了染色体不稳定性 (CIN) 作为mCRC中贝瓦西祖马布反应的潜在生物标志物.
研究的目的:
- 为了比较在德国,爱尔兰和西班牙的mCRC的CIN亚型的第一线化疗中添加bevacizumab的成本效益.
- 评估不同医疗保健成本和报销政策对成本效益的影响.
主要方法:
- 使用来自ANGIOPREDICT队列的数据开发了一个开源健康经济模型.
- 进展风险,死亡率,健康实用设施和不良事件概率来源于文献和联盟医院调查.
- 进行了敏感性分析,以测试结果的稳定性.
主要成果:
- 在任何情况下,贝瓦西祖马布的成本效益都不高,即使在高的支付意愿 (WTP) 门下也是如此.
- 增量成本效益比率 (ICER) 从爱尔兰的180,477欧元/QALY到德国的241,188欧元/QALY不等.
- 敏感性分析证实了这些非成本效益结果的稳定性.
结论:
- 对于mCRC患者,包括CIN亚型患者来说,将贝瓦西祖马布添加到第一线化疗中是不具有成本效益的.
- 尽管各国具体的定价,医疗保健成本和WTP门有所不同,但成本效益仍然不利.
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