Monga Neerav, Garside Jamie, Davids Matthew S, Tam Constantine, Ward Katherine, Fotheringham Iain, O'Donovan Peter, Parisi Lori, Tapprich Christoph
Global Market Access and Health Policy, Janssen Global Oncology, 19 Green Belt Dr, Toronto, ON, M3C 1L9, Canada.
Janssen, HEMAR, High Wycombe, UK.
Pharmacoecon Open. 2021 Jun;5(2):175-186. doi: 10.1007/s41669-020-00231-w.
Mantle cell lymphoma (MCL) is a rare and aggressive subtype of non-Hodgkin's lymphoma. While treatment of patients with MCL and their outcomes are previously published, the availability of heath economics evidence is unclear.
The aim of this paper was to conduct a comprehensive review of studies relating to economic evaluations, costs and resource use, and health-related quality of life (HRQoL) in patients with MCL.
Search strategies were designed to capture studies reporting economic or HRQoL outcomes published in the previous 11 years (2007-2018). The following electronic databases were searched: MEDLINE, Embase, NHS Economic Evaluation Database (NHS EED), and EconLit. In addition, we reviewed congress abstracts presented over the previous 2 years (2015 and 2016; where 2017 proceedings had occurred, these were searched instead of 2015). Publications were screened in duplicate by two reviewers and supplementary searches were carried out on health technology assessment websites. Searches were first conducted in October 2017 and updated in March 2018.
The systematic literature review identified 11 economic evaluations (in 16 publications), seven studies reporting data relating to costs or resource use, and five relating to HRQoL. Four economic evaluations presented results for patients with MCL modelled in the first-line setting, while seven modelled patients in the relapsed/refractory setting. The majority of economic evaluations were conducted using a Markov model with three to five health states. Seven studies assessed resource use and reported adverse events as key drivers of increased costs and resource use. Across the five studies reporting HRQoL, disparate measures were used. Two studies reported improvement in Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) total scores following treatment and found that clinical response to treatment was associated with improvement in overall HRQoL.
The published economic and HRQoL evidence in MCL, although scarce, reveals that the economic and HRQoL burden associated with MCL is substantial. In highlighting this evidence, this analysis underlines a critical unmet need for more effective treatments with improved outcomes in MCL.
套细胞淋巴瘤（MCL）是一种罕见且侵袭性强的非霍奇金淋巴瘤亚型。虽然此前已发表了关于MCL患者的治疗及其预后情况，但卫生经济学证据的可得性尚不清楚。
本文旨在全面综述与MCL患者的经济评估、成本和资源利用以及健康相关生活质量（HRQoL）相关的研究。
设计检索策略以获取在前11年（2007 - 2018年）发表的报告经济或HRQoL结果的研究。检索了以下电子数据库：医学期刊数据库（MEDLINE）、荷兰医学文摘数据库（Embase）、英国国家卫生与临床优化研究所经济评估数据库（NHS EED）和经济文献数据库（EconLit）。此外，我们还查阅了前两年（2015年和2016年；若2017年会议论文集已出版，则检索2017年的而非2015年的）发表的会议摘要。由两名评审员对出版物进行双人筛选，并在卫生技术评估网站上进行补充检索。检索于2017年10月首次进行，并于2018年3月更新。
系统文献综述确定了11项经济评估（在16篇出版物中）、7项报告成本或资源利用相关数据的研究以及5项与HRQoL相关的研究。4项经济评估给出了一线治疗中MCL患者模型的结果，而7项对复发/难治性患者进行了建模。大多数经济评估使用了具有三到五个健康状态的马尔可夫模型。7项研究评估了资源利用情况，并报告不良事件是成本和资源利用增加的主要驱动因素。在报告HRQoL的5项研究中，采用了不同的测量方法。两项研究报告了治疗后癌症治疗 - 淋巴瘤功能评估（FACT - Lym）总分的改善情况，并发现对治疗的临床反应与整体HRQoL的改善相关。
MCL已发表的经济和HRQoL证据虽然稀缺，但显示与MCL相关的经济和HRQoL负担相当大。通过强调这一证据，本分析突显了对MCL中更有效的治疗方法及改善预后的迫切未满足需求。
