Sergio Cedillo, Almudena González-Domínguez, Yoana Ivanova-Markova, Rafael López López, Sara López-Tarruella Cobo, José Alberto Peña Pedrosa
{"title":"西班牙奥拉帕利辅助治疗基因 BRCA1/2 突变、高风险 HER2 阴性早期乳腺癌的成本效用分析。","authors":"Sergio Cedillo, Almudena González-Domínguez, Yoana Ivanova-Markova, Rafael López López, Sara López-Tarruella Cobo, José Alberto Peña Pedrosa","doi":"10.1007/s41669-024-00518-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Here we estimate the cost-effectiveness of olaparib in the Spanish National Health Service (SNHS) as adjuvant treatment of early germline mutations in the BRCA1/2 genes (gBRCAm) HER2-negative (HER2neg) breast cancer (BC) with high risk of recurrence.</p><p><strong>Methods: </strong>A semi-Markov model was adapted to the Spanish healthcare setting, using the perspective of the SNHS, and a lifetime horizon. Two scenarios were compared: receiving olaparib versus standard of care (SoC) treatment. The model comprised five health states and included the clinical results of the OlympiA trial, along with the direct healthcare costs associated with the use of early BC and subsequent treatment resources (€2023). A discount rate of 3% was applied for future cost and quality-of-life outcomes. A probabilistic sensitivity analysis (PSA) was carried out.</p><p><strong>Results: </strong>The introduction of olaparib as adjuvant treatment for patients with early gBRCAm HER2neg BC with high risk of recurrence could involve an incremental cost of €44,273 and €50,164, with an improvement of 1.14 and 1.28 quality-adjusted life years (QALYs) for hormone receptor-positive (HR<sup>+</sup>) and triple-negative (TN) patients, respectively. Therefore, adjuvant olaparib could be cost-effective for early gBRCAm HER2neg BC, with an incremental cost-effectiveness ratio of €38,839/QALY and €39,084/QALY for HR<sup>+</sup> and TN patients, respectively. The results from the PSA showed that 75.7% and 82.2% of the simulations fell below the €60,000/QALY threshold.</p><p><strong>Conclusions: </strong>Olaparib as adjuvant treatment could be cost-effective in gBRCAm patients with early HER2neg BC in Spain.</p>","PeriodicalId":19770,"journal":{"name":"PharmacoEconomics Open","volume":" ","pages":"887-896"},"PeriodicalIF":2.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499548/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cost-Utility Analysis of Adjuvant Olaparib for Germline BRCA1/2-Mutated, High-Risk HER2-Negative Early Breast Cancer in Spain.\",\"authors\":\"Sergio Cedillo, Almudena González-Domínguez, Yoana Ivanova-Markova, Rafael López López, Sara López-Tarruella Cobo, José Alberto Peña Pedrosa\",\"doi\":\"10.1007/s41669-024-00518-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Here we estimate the cost-effectiveness of olaparib in the Spanish National Health Service (SNHS) as adjuvant treatment of early germline mutations in the BRCA1/2 genes (gBRCAm) HER2-negative (HER2neg) breast cancer (BC) with high risk of recurrence.</p><p><strong>Methods: </strong>A semi-Markov model was adapted to the Spanish healthcare setting, using the perspective of the SNHS, and a lifetime horizon. Two scenarios were compared: receiving olaparib versus standard of care (SoC) treatment. The model comprised five health states and included the clinical results of the OlympiA trial, along with the direct healthcare costs associated with the use of early BC and subsequent treatment resources (€2023). A discount rate of 3% was applied for future cost and quality-of-life outcomes. A probabilistic sensitivity analysis (PSA) was carried out.</p><p><strong>Results: </strong>The introduction of olaparib as adjuvant treatment for patients with early gBRCAm HER2neg BC with high risk of recurrence could involve an incremental cost of €44,273 and €50,164, with an improvement of 1.14 and 1.28 quality-adjusted life years (QALYs) for hormone receptor-positive (HR<sup>+</sup>) and triple-negative (TN) patients, respectively. Therefore, adjuvant olaparib could be cost-effective for early gBRCAm HER2neg BC, with an incremental cost-effectiveness ratio of €38,839/QALY and €39,084/QALY for HR<sup>+</sup> and TN patients, respectively. The results from the PSA showed that 75.7% and 82.2% of the simulations fell below the €60,000/QALY threshold.</p><p><strong>Conclusions: </strong>Olaparib as adjuvant treatment could be cost-effective in gBRCAm patients with early HER2neg BC in Spain.</p>\",\"PeriodicalId\":19770,\"journal\":{\"name\":\"PharmacoEconomics Open\",\"volume\":\" \",\"pages\":\"887-896\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499548/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"PharmacoEconomics Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s41669-024-00518-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"PharmacoEconomics Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s41669-024-00518-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：在此，我们估算了西班牙国家医疗服务体系（SNHS）将奥拉帕利作为辅助治疗 BRCA1/2 基因早期种系突变（gBRCAm）HER2 阴性（HER2-neg）乳腺癌（BC）的高复发风险药物的成本效益：从西班牙国家健康调查（SNHS）的角度出发，采用半马尔可夫模型对西班牙的医疗环境进行了调整，并以终生为视角。比较了两种情况：接受奥拉帕利与标准护理（SoC）治疗。该模型由五种健康状态组成，包括 OlympiA 试验的临床结果，以及与使用早期 BC 和后续治疗资源相关的直接医疗成本（2023 欧元）。未来成本和生活质量结果的贴现率为 3%。进行了概率敏感性分析（PSA）：对于复发风险较高的早期 gBRCAm HER2neg BC 患者，采用奥拉帕利作为辅助治疗的增量成本分别为 44,273 欧元和 50,164 欧元，对激素受体阳性（HR+）和三阴性（TN）患者的质量调整生命年（QALYs）分别提高了 1.14 和 1.28。因此，奥拉帕利辅助治疗早期gBRCAm HER2阴性BC具有成本效益，HR+和TN患者的增量成本效益比分别为38839欧元/质量调整生命年和39084欧元/质量调整生命年。PSA结果显示，75.7%和82.2%的模拟结果低于60,000欧元/QALY阈值：结论：奥拉帕利作为辅助治疗药物，对西班牙早期 HER2neg BC 的 gBRCAm 患者具有成本效益。
Cost-Utility Analysis of Adjuvant Olaparib for Germline BRCA1/2-Mutated, High-Risk HER2-Negative Early Breast Cancer in Spain.
Objective: Here we estimate the cost-effectiveness of olaparib in the Spanish National Health Service (SNHS) as adjuvant treatment of early germline mutations in the BRCA1/2 genes (gBRCAm) HER2-negative (HER2neg) breast cancer (BC) with high risk of recurrence.
Methods: A semi-Markov model was adapted to the Spanish healthcare setting, using the perspective of the SNHS, and a lifetime horizon. Two scenarios were compared: receiving olaparib versus standard of care (SoC) treatment. The model comprised five health states and included the clinical results of the OlympiA trial, along with the direct healthcare costs associated with the use of early BC and subsequent treatment resources (€2023). A discount rate of 3% was applied for future cost and quality-of-life outcomes. A probabilistic sensitivity analysis (PSA) was carried out.
Results: The introduction of olaparib as adjuvant treatment for patients with early gBRCAm HER2neg BC with high risk of recurrence could involve an incremental cost of €44,273 and €50,164, with an improvement of 1.14 and 1.28 quality-adjusted life years (QALYs) for hormone receptor-positive (HR+) and triple-negative (TN) patients, respectively. Therefore, adjuvant olaparib could be cost-effective for early gBRCAm HER2neg BC, with an incremental cost-effectiveness ratio of €38,839/QALY and €39,084/QALY for HR+ and TN patients, respectively. The results from the PSA showed that 75.7% and 82.2% of the simulations fell below the €60,000/QALY threshold.
Conclusions: Olaparib as adjuvant treatment could be cost-effective in gBRCAm patients with early HER2neg BC in Spain.
期刊介绍：
PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
