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是否为嵌合体?嵌合抗原受体 T 细胞疗法经济学评价的系统评价——更新

Is it a chimera? A systematic review of the economic evaluations of CAR-T cell therapy - an update.

机构信息

Department of Life and Health Sciences, School of Pharmacy, Pharmacoepidemiology-Pharmacovigilance, University of Nicosia, Nicosia, Cyprus.

Senior Officer, Health Insurance Organization, Nicosia, Cyprus.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(6):625-650. doi: 10.1080/14737167.2023.2214731. Epub 2023 Jun 19.

Abstract

INTRODUCTION

The new class of chimeric antigen receptor T-cell has emboldened health-care professionals and patients for a more effective treatment of hematological malignancies, indicatively lymphoma, acute lymphoblastic leukemia, and myeloma. Nevertheless, their burgeoning procurement costs comprise a litmus stress for health systems across the globe. In this context, this systematic review aims to update the current body of evidence assessing CAR-T economic evaluations and elucidate their financial efficiency.

AREAS COVERED

A systematic review of the economic evaluations of tisagenlecleucel, axicabtagene ciloleucel, idecabtagene vicleucel, lisocabtagene maraleucel, ciltacabtagene autoleucel and brexucabtagene autoleucel was performed.

EXPERT OPINION

The updated results corroborated the previously reported favorable cost-effectiveness ratio of CAR-T. They also pointed out differences among CAR-T agents. However, their budget impact emerges as a significant barrier in the reimbursement process. Any proposed Managed Entry Agreement must integrate the ingrained uncertainty of long-term efficacy and precede reimbursement decisions.

摘要

简介

嵌合抗原受体 T 细胞这一新类别增强了医疗保健专业人员和患者对血液系统恶性肿瘤(如淋巴瘤、急性淋巴细胞白血病和骨髓瘤)更有效治疗的信心。然而,它们不断增长的采购成本对全球卫生系统构成了严峻的压力。在这种情况下,本系统评价旨在更新目前评估嵌合抗原受体 T 细胞经济评估的证据,并阐明其财务效率。

涵盖领域

对 tisagenlecleucel、axicabtagene ciloleucel、idecabtagene vicleucel、lisocabtagene maraleucel、ciltacabtagene autoleucel 和 brexucabtagene autoleucel 的经济评估进行了系统评价。

专家意见

更新后的结果证实了之前报道的嵌合抗原受体 T 细胞具有良好的成本效益比。它们还指出了不同嵌合抗原受体 T 细胞药物之间的差异。然而,它们的预算影响在报销过程中成为一个重大障碍。任何拟议的管理准入协议都必须整合长期疗效的固有不确定性,并在报销决策之前做出。

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