白蛋白结合型紫杉醇联合吉西他滨治疗转移性胰腺癌在英国的经济学评估。
Economic evaluation for the UK of nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreas cancer.
作者信息
Gharaibeh M, McBride A, Bootman J L, Abraham I
机构信息
Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA.
Arizona Cancer Center, University of Arizona, Tucson, AZ 85721, USA.
出版信息
Br J Cancer. 2015 Apr 14;112(8):1301-5. doi: 10.1038/bjc.2015.65. Epub 2015 Mar 19.
BACKGROUND
The combination of nab-paclitaxel plus gemcitabine (NAB-P+GEM) has shown superior efficacy over GEM monotherapy in metastatic pancreas cancer (MPC). Independent cost-effectiveness/utility analyses of NAB-P+GEM from the payer perspective have not been conducted for the UK.
METHODS
A Markov model simulating the health outcomes and total costs was developed to estimate the life years gained (LYG) and quality-adjusted life years gained (QALY) and incremental cost-effectiveness (ICER) and cost-utility ratios (ICUR) for patients with MPC in a base case and in a probabilistic (PSA) sensitivity analysis. Total cost included the cost of supportive care medications, administration, chemotherapy, disease monitoring, and adverse reactions; and was discounted at 3.5% per year. A full lifetime horizon and third party payer perspective was chosen.
RESULTS
The total cost of NAB-P+GEM was £5466 higher than the cost for GEM. Respectively, LYGs were 0.97 vs 0.79 and QALYs were 0.52 vs 0.45, with ICER of £30 367/LYG and ICUR of £78 086/QALY, confirmed by PSA.
CONCLUSIONS
The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.
背景
在转移性胰腺癌（MPC）的治疗中，纳米白蛋白结合型紫杉醇联合吉西他滨（NAB - P+GEM）已显示出优于吉西他滨单药治疗的疗效。尚未从英国支付方的角度对NAB - P+GEM进行独立的成本效益/效用分析。
方法
建立了一个模拟健康结局和总成本的马尔可夫模型，以估计MPC患者在基础病例和概率性（PSA）敏感性分析中的生命年增益（LYG）、质量调整生命年增益（QALY）、增量成本效益（ICER）和成本效用比（ICUR）。总成本包括支持性护理药物、给药、化疗、疾病监测和不良反应的成本；并按每年3.5%进行贴现。选择了完整的终身视角和第三方支付方视角。
结果
NAB - P+GEM的总成本比吉西他滨高5466英镑。LYG分别为0.97对0.79，QALY分别为0.52对0.45，PSA证实ICER为30367英镑/LYG，ICUR为78086英镑/QALY。
结论
在MPC治疗中，NAB - P+GEM相对于吉西他滨具有更好的生存疗效，且具有积极的成本效益和成本效用。
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