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神经内分泌肿瘤患者中奥曲肽与兰瑞肽的真实世界治疗模式、医疗资源利用和成本分析。

Analysis of Real-World Treatment Patterns, Healthcare Resource Utilization, and Costs Between Octreotide and Lanreotide Among Patients With Neuroendocrine Tumors.

机构信息

From the Analysis Group, Inc, Boston, MA.

Novartis Pharmaceuticals Corporation, East Hanover, NJ.

出版信息

Pancreas. 2019 Oct;48(9):1126-1135. doi: 10.1097/MPA.0000000000001403.

Abstract

OBJECTIVE

The aim of the study was to assess treatment patterns, healthcare resource utilization, and healthcare costs among patients with neuroendocrine tumors (NETs) receiving long-acting octreotide versus lanreotide, overall and in patients with carcinoid syndrome (CS).

METHODS

A provider-based claims database was used to identify NET patients who first initiated long-acting octreotide or lanreotide (index date) from January 2015 to November 2017. Propensity-score matching 1:1 was used. Patients with CS were identified from the previously mentioned matched cohorts. Time-to-treatment discontinuation (TTD) was estimated using Kaplan-Meier analyses. Per-patient-per-month rates of healthcare resource utilization were compared using rate ratios from multivariable Poisson regression models. Multivariable linear regression models were used to compare mean monthly cost differences.

RESULTS

The median TTD was similar between the 2 matched cohorts (N = 543 each; long-acting octreotide = 19.2 months, lanreotide = 17.5 months, P = 0.58). Significantly fewer NET-related outpatient visits (rate ratio = 0.95, P = 0.005) and significantly lower total healthcare costs (mean monthly cost difference: all-cause = US -$3701, NET-related = US -$3752, Ps < 0.001) were observed in the long-acting octreotide cohort than lanreotide. Similar results were found in CS patients.

CONCLUSIONS

Patients on first-line long-acting octreotide and lanreotide had similar TTD. Long-acting octreotide was associated with significantly lower total healthcare costs than lanreotide.

摘要

目的

本研究旨在评估接受长效奥曲肽和兰瑞肽治疗的神经内分泌肿瘤(NET)患者的治疗模式、医疗资源利用情况和医疗成本,包括总体情况和类癌综合征(CS)患者的情况。

方法

使用基于提供者的索赔数据库,从 2015 年 1 月至 2017 年 11 月,确定首次开始长效奥曲肽或兰瑞肽治疗的 NET 患者(索引日期)。采用倾向评分匹配 1:1 法。从上述匹配队列中确定 CS 患者。采用 Kaplan-Meier 分析估计治疗终止时间(TTD)。采用多变量泊松回归模型的率比比较每个患者每月的医疗资源利用率。采用多元线性回归模型比较平均每月成本差异。

结果

两组匹配队列的中位 TTD 相似(N=543 例,长效奥曲肽组为 19.2 个月,兰瑞肽组为 17.5 个月,P=0.58)。长效奥曲肽组 NET 相关门诊就诊次数明显减少(率比=0.95,P=0.005),总医疗费用明显降低(全因=每月节省 3701 美元,NET 相关=每月节省 3752 美元,均 P<0.001)。CS 患者也观察到了类似的结果。

结论

接受一线长效奥曲肽和兰瑞肽治疗的患者 TTD 相似。长效奥曲肽的总医疗成本明显低于兰瑞肽。

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