Lafuma A, Dreno B, Delaunay M, Emery C, Fagnani F, Hieke K, Bonerandi J J, Grob J J
Cemka, 43 boulevard du Maréchal Joffre, F-92340, Bourg-la-Reine, France.
Eur J Cancer. 2001 Feb;37(3):369-75. doi: 10.1016/s0959-8049(00)00411-1.
Using the trial demonstrating that interferonalpha-2a (IFNalpha-2a) is efficacious as adjuvant therapy in stage II melanoma, we evaluate its outcomes and economic consequences. Using rates observed in the 5-year trial and published figures, survival and Q-TWIST (Time Without Symptoms and Toxicity) were extrapolated to a 10-year and lifetime horizon. Cost analysis was performed using the trial's data, published literature and experts' opinions from the perspective of the French Sickness Funds. Patients in the IFNalpha-2a-group have an additional 0.26 years in life-expectancy over a 5-year time period (P=0.046), 0.67 years over a 10-year period and 2.59 years over a lifetime. Cost per life-year-gained was estimated at approximately 14400 after 5 years, 6635 after 10 years and 1716 over a lifetime. Assuming that there is an improvement in disease-free survival only, cost is 26147 per Q-TWIST. Cost-effectiveness of IFNalpha-2a in stage II melanoma compares favourably with estimates for widely used therapies in the oncological field.
利用一项试验（该试验表明α-2a干扰素（IFNα-2a）作为II期黑色素瘤的辅助治疗有效），我们评估了其治疗结果和经济影响。利用在为期5年的试验中观察到的发生率以及已发表的数据，将生存率和无病症及毒性时间（Q-TWIST）外推至10年和终生范围。从法国疾病基金的角度出发，利用试验数据、已发表的文献和专家意见进行了成本分析。IFNα-2a组患者在5年期间预期寿命增加0.26年（P=0.046），10年期间增加0.67年，终生增加2.59年。5年后每获得一个生命年的成本估计约为14400，10年后为6635，终生为1716。假设仅无病生存期有所改善，每个Q-TWIST的成本为26147。IFNα-2a在II期黑色素瘤治疗中的成本效益与肿瘤学领域广泛使用的疗法的估计值相比具有优势。
