University Hospital Jena, Jena, Germany.
German Cancer Research Center, Heidelberg, Germany.
PLoS One. 2022 Dec 1;17(12):e0278460. doi: 10.1371/journal.pone.0278460. eCollection 2022.
This study evaluated factors that influence the cost-effectiveness of talazoparib, particularly for patients with a germline breast-cancer-gene-(brca)-mutation and locally advanced or metastasized breast cancer within the context of the German healthcare system. We constructed a partitioned survival model to compare medical costs and treatment effectiveness for patients with such cancers over 45 months. Transition probabilities were derived from survival data from a randomized Phase-III EMBRACA trial, utilities based on published reports, and costs in Euros, which included costs for drug acquisition, clinical monitoring, and treatment of adverse events. Willingness-to-pay thresholds were set to be multiples of the current German per capita gross domestic product. Treatment with talazoparib led to a gain of 0.32 life-years (0.22 quality-adjusted life-years). The mean total cost of €84,003 for talazoparib and €12,741 for standard therapy resulted in an incremental cost-effectiveness ratio of €223,246 per life-year and €323,932 per quality-adjusted life-year gained, indicating that talazoparib is unlikely to be cost-effective at current pricing.
本研究评估了影响他拉唑帕利成本效益的因素，特别是在德国医疗体系下，对于携带种系乳腺癌基因（BRCA）突变的局部晚期或转移性乳腺癌患者。我们构建了一个分割生存模型，以比较此类癌症患者在 45 个月内的医疗成本和治疗效果。转移概率源自随机 III 期 EMBRACA 试验的生存数据、基于已发表报告的效用值以及以欧元计价的成本，其中包括药物获取、临床监测和不良事件治疗的成本。意愿支付阈值设定为当前德国人均国内生产总值的倍数。使用他拉唑帕利治疗可获得 0.32 年的生命（0.22 年质量调整生命）。他拉唑帕利的平均总成本为 84003 欧元，标准治疗的平均总成本为 12741 欧元，导致每例生命年增量成本效益比为 223246 欧元，每例质量调整生命年增量成本效益比为 323932 欧元，表明按现行价格，他拉唑帕利不太可能具有成本效益。
