化放疗加免疫疗法治疗局部晚期鼻咽癌:成本效益分析。

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
Kun Liu, Youwen Zhu, Shan Li, Hong Zhu
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引用次数: 0

摘要

背景:在癌症患者的放化疗方案中加入免疫检查点抑制剂(ICIs)的研究越来越普遍,显示出有望改善疗效的结果。对于局部晚期鼻咽癌(NPC)患者来说,将免疫疗法与化疗放疗相结合有助于显著延长患者的生存期,因此有必要开展药物经济学研究,重点关注这些创新治疗方案的临床应用情况:方法:根据CONTINUUM 3期随机试验的临床数据建立了一个三态马尔可夫模型,并用于比较化放疗加辛替利单抗(辛替利单抗组)与单纯化放疗(标准组)的成本效益、分析结果包括增量成本效益比 (ICER)、增量净货币效益 (INMB) 和增量净健康效益 (INHB),其支付意愿 (WTP) 临界值相当于中国人均 GDP 的三倍(每质量调整生命年 [QALY] 37 035 美元)。结果:辛替利单抗组和标准组患者的总成本(QALYs [LYs])分别为 92 116 美元(6.68 [10.03])和 53 255 美元(3.75 [5.55]),ICER 为 13 230 美元/QALY(8672 美元/LY),INMB 为 70 021 美元,INHB 为 1.89 QALYs。使用选定的 WTP 临界值。在标准 WTP 临界值上,中国辛替利单抗组作为主要治疗方法的患病率为 90.55%。模型的建立是稳定的:结论:在化放疗方案中加入辛替利单抗是中国治疗局部晚期鼻咽癌患者的一种创新且具有成本效益的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chemoradiotherapy plus immunotherapy for locoregionally advanced nasopharyngeal carcinoma: A cost-effectiveness analysis.

Background: Research focused on the addition of immune checkpoint inhibitors (ICIs) to radiotherapeutic regimens in patients with cancer has become increasingly common, revealing promising improvements in efficacy outcomes. In patients with locoregionally advanced nasopharyngeal carcinoma (NPC), combining immunotherapy with chemoradiotherapy can facilitate the significant prolongation of survival, emphasizing the need for pharmacoeconomic studies focused on the clinical uptake of these innovative treatment regimens.

Methods: A three-state Markov model was developed based on clinical data from the randomized phase 3 CONTINUUM trial and used to compare the cost-effectiveness of chemoradiotherapy plus sintilimab (sintilimab group) to chemoradiotherapy alone (standard group), analyzing outcomes including incremental cost-effectiveness ratio (ICER), incremental net monetary benefit (INMB), and incremental net-health benefit (INHB) values at a willingness-to-pay (WTP) threshold corresponding to three times the Chinese GDP per capita ($37 035 per quality-adjusted life year [QALY]).

Results: The total costs for patients in the sintilimab and standard groups (QALYs [LYs]) were $92 116 (6.68 [10.03]) and $53 255 (3.75 [5.55]), respectively, for an ICER of $13 230/QALY ($8672/LY), an INMB of $70 021 with INHB of 1.89 QALYs. Using the selected WTP threshold. On the standard WTP threshold, the prevalence of sintilimab group as the primary treatment was 90.55% in China. The establishment of the model is stable.

Conclusions: Adding sintilimab to chemoradiotherapeutic regimens represents an innovative and cost-effective means for patients with locoregionally advanced NPC management in China.

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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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