Saret Cayla J, Winn Aaron N, Shah Gunjan, Parsons Susan K, Lin Pei-Jung, Cohen Joshua T, Neumann Peter J
Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA;
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and.
Blood. 2015 Mar 19;125(12):1866-9. doi: 10.1182/blood-2014-07-592832. Epub 2015 Feb 5.
We analyzed cost-effectiveness studies related to hematologic malignancies from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), focusing on studies of innovative therapies. Studies that met inclusion criteria were categorized by 4 cancer types (chronic myeloid leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and multiple myeloma) and 9 treatment agents (interferon-α, alemtuzumab, bendamustine, bortezomib, dasatinib, imatinib, lenalidomide, rituximab alone or in combination, and thalidomide). We examined study characteristics and stratified cost-effectiveness ratios by type of cancer, treatment, funder, and year of study publication. Twenty-nine studies published in the years 1996-2012 (including 44 cost-effectiveness ratios) met inclusion criteria, 22 (76%) of which were industry funded. Most ratios fell below $50,000 per quality-adjusted life-years (QALY) (73%) and $100,000/QALY (86%). Industry-funded studies (n = 22) reported a lower median ratio ($26,000/QALY) than others (n = 7; $33,000/QALY), although the difference was not statistically significant. Published data suggest that innovative treatments for hematologic malignancies may provide reasonable value for money.
我们从塔夫茨医学中心成本效益分析注册库(www.cearegistry.org)分析了与血液系统恶性肿瘤相关的成本效益研究,重点关注创新疗法的研究。符合纳入标准的研究按4种癌症类型(慢性髓性白血病、慢性淋巴细胞白血病、非霍奇金淋巴瘤和多发性骨髓瘤)和9种治疗药物(α干扰素、阿仑单抗、苯达莫司汀、硼替佐米、达沙替尼、伊马替尼、来那度胺、单独或联合使用的利妥昔单抗以及沙利度胺)进行分类。我们检查了研究特征,并按癌症类型、治疗方法、资助者和研究发表年份对成本效益比进行分层。1996年至2012年发表的29项研究(包括44个成本效益比)符合纳入标准,其中22项(76%)由行业资助。大多数比值低于每质量调整生命年(QALY)50,000美元(73%)和100,000美元/QALY(86%)。行业资助的研究(n = 22)报告的中位数比值(26,000美元/QALY)低于其他研究(n = 7;33,000美元/QALY),尽管差异无统计学意义。已发表的数据表明,血液系统恶性肿瘤的创新治疗可能具有合理的性价比。