头颈部癌症的单克隆抗体治疗对生命终末期护理利用和成本的影响。
Impact of monoclonal antibody therapy for head and neck cancer on end-of-life care utilization and costs.
机构信息
University of Michigan Medical School, Ann Arbor, Michigan, USA.
Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
出版信息
Head Neck. 2023 Jun;45(6):1468-1475. doi: 10.1002/hed.27359. Epub 2023 Mar 28.
BACKGROUND
The impact of monoclonal antibody therapy (mAB) for advanced head and neck cancer on end-of-life health care utilization and costs has yet to be adequately studied.
METHODS
Retrospective cohort study of patients aged 65 and over with a diagnosis of head and neck cancer between 2007 and 2017 within the SEER-Medicare registry assessing the impact of mAB therapy (i.e., cetuximab, nivolumab, or pembrolizumab) on end-of-life health care utilization (ED visits, inpatient admissions, ICU admissions, and hospice claims) and costs.
RESULTS
Of 12 544 patients with HNC, 270 (2.2%) utilized mAB therapy at the end-of-life period. On multivariable analyses adjusting for demographic and clinicopathologic characteristics, there was a significant association between mAB therapy and emergency department visits (OR: 1.38, 95% CI: 1.1-1.8, p = 0.01) and healthcare costs (β: $9760, 95% CI: 5062-14 458, p < 0.01).
CONCLUSIONS
mAB use is associated with higher emergency department utilization and health care costs potentially due to infusion-related and drug toxicity expenses.
背景
单克隆抗体治疗（mAB）对晚期头颈部癌症患者的生命终末期医疗保健利用和成本的影响尚未得到充分研究。
方法
这是一项回顾性队列研究，纳入了 2007 年至 2017 年间 SEER-Medicare 注册中心年龄在 65 岁及以上、诊断为头颈部癌症的患者，评估 mAB 治疗（即西妥昔单抗、纳武单抗或帕博利珠单抗）对生命终末期医疗保健利用（急诊就诊、住院入院、重症监护病房入院和临终关怀索赔）和成本的影响。
结果
在 12544 例 HNC 患者中，270 例（2.2%）在生命终末期使用 mAB 治疗。在调整人口统计学和临床病理特征的多变量分析中，mAB 治疗与急诊科就诊（OR：1.38，95%CI：1.1-1.8，p=0.01）和医疗保健费用（β：$9760，95%CI：5062-14458，p<0.01）显著相关。
结论
mAB 的使用与更高的急诊科就诊利用率和医疗保健费用相关，这可能是由于输注相关和药物毒性费用所致。
Zotero 插件