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评估在美国杜兴氏肌营养不良症患者中使用地兰妥昔单抗莫克帕维(SRP-9001)基因疗法的价值。

Assessing the value of delandistrogene moxeparvovec (SRP-9001) gene therapy in patients with Duchenne muscular dystrophy in the United States.

作者信息

Klimchak Alexa C, Sedita Lauren E, Rodino-Klapac Louise R, Mendell Jerry R, McDonald Craig M, Gooch Katherine L, Malone Daniel C

机构信息

Global HEOR, RWE & Analytics, Sarepta Therapeutics, Inc, Cambridge, MA, USA.

Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

出版信息

J Mark Access Health Policy. 2023 May 26;11(1):2216518. doi: 10.1080/20016689.2023.2216518. eCollection 2023.

Abstract

: Delandistrogene moxeparvovec (SRP-9001) is an investigational gene therapy that may delay progression of Duchenne muscular dystrophy (DMD), a severe, rare neuromuscular disease caused by gene mutations. Early cost-effectiveness analyses are important to help contextualize the value of gene therapies for reimbursement decision making. : To determine the potential value of delandistrogene moxeparvovec using a cost-effectiveness analysis. : A simulation calculated lifetime costs and equal value of life years gained (evLYG). Inputs included extrapolated clinical trial results and published utilities/costs. As a market price for delandistrogene moxeparvovec has not been established, threshold analyses established maximum treatment costs as they align with value, including varying willingness-to-pay up to $500,000, accounting for severity/rarity. : USA, healthcare system perspective : Boys with DMD : Delandistrogene moxeparvovec plus standard of care (SoC; corticosteroids) versus SoC alone : Maximum treatment costs at a given willingness-to-pay threshold : Delandistrogene moxeparvovec added 10.30 discounted (26.40 undiscounted) evLYs. The maximum treatment cost was approximately $5 M, assuming $500,000/evLYG. Varying the benefit discount rate to account for the single administration increased the estimated value to #$5M, assuming $500,000/evLYG. : In this early economic model, delandistrogene moxeparvovec increases evLYs versus SoC and begins to inform its potential value from a healthcare perspective.

摘要

德蓝地昔单抗(SRP-9001)是一种研究性基因疗法,可能延缓杜氏肌营养不良症(DMD)的进展,DMD是一种由基因突变引起的严重罕见神经肌肉疾病。早期成本效益分析对于帮助确定基因疗法在报销决策中的价值背景非常重要。

目的

通过成本效益分析确定德蓝地昔单抗的潜在价值。

方法

通过模拟计算终身成本和获得的等效生命年价值(evLYG)。输入包括外推的临床试验结果和已发表的效用/成本。由于德蓝地昔单抗的市场价格尚未确定,阈值分析确定了与价值相符的最高治疗成本,包括高达50万美元的不同支付意愿,同时考虑了疾病的严重程度/罕见性。

视角

美国医疗保健系统

研究对象

患有DMD的男孩

比较

德蓝地昔单抗联合标准治疗(SoC;皮质类固醇)与单独使用SoC

结果

在给定的支付意愿阈值下的最高治疗成本

德蓝地昔单抗增加了10.30个贴现(26.40个未贴现)的evLYs。假设每evLYG为50万美元,则最高治疗成本约为500万美元。考虑到单次给药而改变效益贴现率后,假设每evLYG为50万美元,估计价值增至500万美元。

结论

在这个早期经济模型中,与标准治疗相比,德蓝地昔单抗增加了evLYs,并开始从医疗保健角度说明其潜在价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afd2/10228300/335102582166/ZJMA_A_2216518_F0001_B.jpg

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