Norum J, Olsen J A, Wist E A, Lønning P E
Department of Oncology, University Hospital of North Norway, Tromsø, Norway.
Acta Oncol. 2007;46(2):153-64. doi: 10.1080/02841860601096841.
Trastuzumab has shown activity in early breast cancer patients that overexpress HER2. Significant resources have to be allocated to finance this therapy, underlining the need for cost-effectiveness analysis. A model was set up, societal costs were calculated and the discount rate was 3%. Life expectancy data were based on the literature and prolonged according to qualified guess (10% and 20% absolute improvement in overall survival (OS)). The comparator was the FEC(100) regimen. The median additional health care cost per patient treated was 33,597 euros. The yielding cost per life year gained (LYG) was 15,341 euros with a 20% improved OS and 35,947 euros with 10% improved OS. The corresponding net health care cost per quality adjusted life year (QALY) was 19,176 euros and 44,934 euros. Including all resource use the figures were 8148 euros and 30,290 euros per LYG. Sensitivity analyses documented survival gain, price of trastuzumab, production gain and discount rate to be the major factors influencing cost-effectiveness ratio. Trastuzumab is indicated cost effective in Norway.
曲妥珠单抗已在过表达HER2的早期乳腺癌患者中显示出活性。必须分配大量资源来资助这种治疗，这突出了成本效益分析的必要性。建立了一个模型，计算了社会成本，贴现率为3%。预期寿命数据基于文献，并根据合理猜测进行延长（总生存期（OS）绝对提高10%和20%）。对照方案是FEC(100)方案。每位接受治疗的患者的额外医疗保健成本中位数为33,597欧元。在OS提高20%的情况下，每获得一个生命年（LYG）的成本效益为15,341欧元，在OS提高10%的情况下为35,947欧元。每个质量调整生命年（QALY）相应的净医疗保健成本为19,176欧元和44,934欧元。包括所有资源使用情况，每LYG的数字分别为8148欧元和30,290欧元。敏感性分析表明，生存获益、曲妥珠单抗价格、生产获益和贴现率是影响成本效益比的主要因素。在挪威，曲妥珠单抗被证明具有成本效益。
