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阿替利珠单抗联合贝伐单抗及化疗与贝伐单抗联合化疗治疗转移性宫颈癌的成本效益分析

Atezolizumab plus bevacizumab and chemotherapy versus bevacizumab plus chemotherapy for metastatic cervical cancer: a cost-effectiveness analysis.

作者信息

Cai Hongfu, Fang Ling, Lin Jingwen, Zheng Zhiwei

机构信息

Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.

Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China.

出版信息

Front Pharmacol. 2024 Oct 21;15:1476256. doi: 10.3389/fphar.2024.1476256. eCollection 2024.

Abstract

AIM

The objective of this study is to conduct a cost-effectiveness analysis in order to evaluate the economic advantages of incorporating atezolizumab into a standard bevacizumab plus platinum regimen for the treatment of metastatic cervical cancer from the Chinese medical system perspective.

METHOD

We developed a partitioned survival model based on data obtained from the recently published BEATcc clinical trial and economic cost data. Our model utilized a tree-based decision analysis approach to simulate two different treatment strategies for metastatic cervical cancer: the standard bevacizumab plus platinum regimen, and the addition of atezolizumab to the standard treatment regimen. The economic assessment data included the costs of the drugs, costs related to treatment-induced adverse events. The cost-effectiveness metrics used in the analysis were quality-adjusted life-year (QALY) and incremental cost-effectiveness ratio (ICER). The robustness of our model was assessed through sensitivity analysis.

RESULT

The total costs of the atezolizumab group were $128179.56, while the costs of chemotherapy group were $42065.89. The atezolizumab group gained 3.52 QALYs, whereas the chemotherapy group gained 2.35 QALY. The atezolizumab regimen resulted in an increase of 1.17 QALYs at an incremental cost of $86113.67. This led to an ICER of $73601.43, which exceeds the willingness-to-pay (WTP) threshold of $39855.79 in China. Sensitivity analysis demonstrated none of the parameters within a margin of ±25% result in significant alterations to the analysis findings.

CONCLUSION

Atezolizumab plus bevacizumab and chemotherapy was not to be a cost-effective option for the treatment of metastatic cervical cancer compared to bevacizumab plus chemotherapy.

摘要

目的

本研究的目的是进行成本效益分析,以便从中国医疗系统的角度评估将阿替利珠单抗纳入标准贝伐单抗加铂类方案治疗转移性宫颈癌的经济优势。

方法

我们基于最近发表的BEATcc临床试验获得的数据和经济成本数据开发了一个分区生存模型。我们的模型采用基于树的决策分析方法来模拟转移性宫颈癌的两种不同治疗策略:标准贝伐单抗加铂类方案,以及在标准治疗方案中添加阿替利珠单抗。经济评估数据包括药物成本、与治疗引起的不良事件相关的成本。分析中使用的成本效益指标是质量调整生命年(QALY)和增量成本效益比(ICER)。我们通过敏感性分析评估了模型的稳健性。

结果

阿替利珠单抗组的总成本为128179.56美元,而化疗组的成本为42065.89美元。阿替利珠单抗组获得3.52个QALY,而化疗组获得2.35个QALY。阿替利珠单抗方案导致QALY增加1.17个,增量成本为86113.67美元。这导致ICER为73601.43美元,超过了中国39855.79美元的支付意愿(WTP)阈值。敏感性分析表明,在±25%的范围内,没有一个参数会导致分析结果发生显著变化。

结论

与贝伐单抗加化疗相比,阿替利珠单抗加贝伐单抗和化疗不是治疗转移性宫颈癌的成本效益选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a27/11532157/14e089605279/fphar-15-1476256-g001.jpg

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