Chen Ying, Pan Jiahua, Zhong Yan, Wu Bin, Yan Mengxia, Zhang Ruiyun
Clinical Research Institute, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200000, People's Republic of China.
Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200000, People's Republic of China.
Clinicoecon Outcomes Res. 2024 Dec 13;16:869-875. doi: 10.2147/CEOR.S485856. eCollection 2024.
Prostate Cancer can be treated with various formulations of Gonadotropin-Releasing Hormone Agonists (GnRHa), but cost analyses of these treatments in China are lacking. This study aims to evaluate the differences in cost and resource utilization between various formulations of GnRHa for Prostate Cancer by conducting a resource utilization assessment and cost minimization analysis.
From the perspective of society and medical healthcare, this study used the cost minimization model to generate cost and resource estimates for GnRHa drug acquisition and administration for "Current practice" and for a "Base case" scenario. In the "Base case" scenario, all of the patients who were receiving 1-monthly or 3-monthly GnRHa therapy in "Current practice" switched to a 6-monthly formulation triptorelin. Cost/Resource estimates were calculated per patient per administration and scaled to annualized population levels. Deterministic sensitivity analysis was conducted to explore the uncertainty of the model variables and applied assumptions.
From a societal perspective, if all 1-monthly and 3-monthly formulations of GnRHa were switched to a 6-monthly formulation triptorelin, it is conservatively estimated that the annual societal cost could be reduced by ¥13,382,951.13, with an average annual cost savings of ¥46.53 per patient. Additionally, the 6-monthly formulation could save 3,608,973.91 hours annually, translating to an average time savings of 12.55 hours per patient, reducing treatment time by 78%. From a healthcare system perspective, if the introduction of the 6-monthly formulation of GnRHa is delayed, it would lead to an annual increase of ¥94 million in medical costs, and require an additional 64,445.96 working days for doctors and nurses. Deterministic sensitivity analysis demonstrated the model's robustness, showing the 6-monthly GnRHa remains cost-effective across various parameter changes, with drug price being the most influential factor.
Compared to current 1-monthly and 3-monthly formulations, the 6-monthly GnRHa can reduce the total burden associated with prostate cancer treatment.
前列腺癌可用多种促性腺激素释放激素激动剂(GnRHa)制剂进行治疗,但中国缺乏这些治疗方法的成本分析。本研究旨在通过进行资源利用评估和成本最小化分析,评估不同GnRHa制剂治疗前列腺癌在成本和资源利用方面的差异。
从社会和医疗保健的角度出发,本研究使用成本最小化模型来生成GnRHa药物采购和给药的成本及资源估计值,用于“当前实践”和“基础案例”情景。在“基础案例”情景中,所有在“当前实践”中接受每月或每三个月一次GnRHa治疗的患者都改用每六个月一次的曲普瑞林制剂。成本/资源估计值按每次给药每位患者计算,并按年度人口水平进行缩放。进行确定性敏感性分析以探索模型变量和应用假设的不确定性。
从社会角度来看,如果将所有每月和每三个月一次的GnRHa制剂都改用每六个月一次的曲普瑞林制剂,保守估计每年社会成本可降低13382951.13元,每位患者平均每年节省成本46.53元。此外,每六个月一次的制剂每年可节省3608973.91小时,每位患者平均节省时间12.55小时,治疗时间减少78%。从医疗系统角度来看,如果推迟引入每六个月一次的GnRHa制剂,将导致医疗成本每年增加9400万元,医生和护士需要额外工作64445.96个工作日。确定性敏感性分析证明了该模型的稳健性,表明每六个月一次的GnRHa在各种参数变化下仍具有成本效益,其中药品价格是最具影响力的因素。
与目前每月和每三个月一次的制剂相比,每六个月一次的GnRHa可减轻前列腺癌治疗的总体负担。