Gharaibeh M, McBride A, Bootman J L, Abraham I
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.
Br J Cancer. 2015 Apr 14;112(8):1301-5. doi: 10.1038/bjc.2015.65. Epub 2015 Mar 19.
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.
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.
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.
The superior survival efficacy of NAB-P+GEM over GEM in the management of MPC is associated with positive cost-effectiveness and cost-utility.
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。
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。
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。
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。
