Liviu Preda Alin, Galieta Mincă Dana
Public Health and Management Department, Carol Davila University of Medicine and Pharmacy, Bucharest.
J Med Life. 2018 Oct-Dec;11(4):306-311. doi: 10.25122/jml-2018-0069.
In recent years, the cost of several treatment options for renal cancer have been supported by the Romanian healthcare system for both first- and second-line therapies. First-line alternatives through real-life efficacy and amplitude of adverse reactions may influence the efficacy and costs of patients treated with second-line treatment. Estimation of the cost-effectiveness and cost-benefit ratio for first-line treatment alternatives: Sunitinib and Pazopanib from the payer's perspective in the Romanian healthcare system. We developed a Markov model to calculate the cost-effectiveness and cost-benefit ratio for 2 cohorts of patients using the results from the COMPARZ study for efficacy (progression-free survival, general survivability and quality of life) and safety and costs from national hospital databases. For an estimated population of 800 patients, Pazopanib has a quantified benefit of 7.19 years in progression-free survival, 11.71 life years gained and 8.97 years of quality-adjusted life-years compared to Sunitinib. The analysis is limited by the accuracy of the national data used and the transposition of general data on efficacy and safety at the local level.
近年来，罗马尼亚医疗保健系统为肾癌的几种治疗方案的费用提供了支持，包括一线和二线治疗。通过实际疗效和不良反应程度的一线替代方案可能会影响接受二线治疗患者的疗效和费用。从罗马尼亚医疗保健系统支付方的角度评估一线治疗替代方案（舒尼替尼和帕唑帕尼）的成本效益和成本效益比。我们开发了一个马尔可夫模型，利用COMPARZ研究的疗效结果（无进展生存期、总体生存率和生活质量）以及国家医院数据库中的安全性和成本数据，计算两组患者的成本效益和成本效益比。对于估计的800名患者群体，与舒尼替尼相比，帕唑帕尼在无进展生存期的量化获益为7.19年，获得11.71个生命年和8.97个质量调整生命年。该分析受到所用国家数据准确性以及在地方层面转换疗效和安全性一般数据的限制。
