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抗血管内皮生长因子治疗年龄相关性黄斑变性的成本效益:巴西视角

Cost-effectiveness of Anti-VEGF treatments for age-related macular degeneration: a Brazilian perspective.

作者信息

Nunes Renata Portella, Hirai Flávio Eduardo, Rodrigues Eduardo Buchelle, Farah Michel Eid

机构信息

Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Instituto de Olhos de Florianópolis, Florianópolis, SC, Brazil.

出版信息

Arq Bras Oftalmol. 2020 Jan-Feb;83(1):48-54. doi: 10.5935/0004-2749.20200020.

Abstract

PURPOSE

To study the cost-effectiveness of ranibizumab and bevacizumab for the treatment of age-related macular degeneration.

METHODS

We used a decision tree model to analyze the cost-effectiveness of ranibizumab and bevacizumab for the treatment of age-related macular degeneration, from the Brazilian Public Health System (SUS) perspective. Ranibizumab and bevacizumab were administered to patients with the same treatment procedure, and the difference in treatment costs was calculated based on the cost of the drugs. Direct costs were estimated using the information provided by the Brazilian SUS. Effectiveness in terms of quality-adjusted life years (QALYs) was calculated based on the utility values for visual impairment. Incremental cost-effectiveness ratio was calculated by comparing both treatments. The analytical horizon was one year.

RESULTS

The decision tree analysis showed that the difference in treatment effectiveness was 0.01 QALY. Incremental cost-effectiveness ratio showed that ranibizumab treatment required an incremental annual cost of more than R$ 2 million to generate 1 additional QALY, as compared to bevacizumab.

CONCLUSIONS

From the Brazilian SUS perspective, bevacizumab is more cost-effective than ranibizumab for the treatment of neovascular age-related macular degeneration. Its use could allow potential annual savings in health budget.

摘要

目的

研究雷珠单抗和贝伐单抗治疗年龄相关性黄斑变性的成本效益。

方法

我们采用决策树模型,从巴西公共卫生系统(SUS)的角度分析雷珠单抗和贝伐单抗治疗年龄相关性黄斑变性的成本效益。雷珠单抗和贝伐单抗对患者采用相同的治疗程序,并根据药物成本计算治疗成本差异。直接成本根据巴西SUS提供的信息进行估算。基于视力损害的效用值计算质量调整生命年(QALY)方面的有效性。通过比较两种治疗方法计算增量成本效益比。分析期限为一年。

结果

决策树分析表明,治疗效果差异为0.01 QALY。增量成本效益比显示,与贝伐单抗相比,雷珠单抗治疗每产生1个额外的QALY需要每年增加超过200万雷亚尔的成本。

结论

从巴西SUS的角度来看,在治疗新生血管性年龄相关性黄斑变性方面,贝伐单抗比雷珠单抗更具成本效益。使用贝伐单抗可在年度卫生预算中实现潜在节省。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/167b/11984439/672a56481828/abo-83-01-0048-g01.jpg

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