评估抗pd -1/ PD-L1抑制剂对希腊癌症护理健康和预算的影响

IF 2 Q3 HEALTH POLICY & SERVICES

Journal of Cancer Policy Pub Date : 2025-07-27 DOI:10.1016/j.jcpo.2025.100628

Danai Ktena , Panagiota Naoum , Evie Dalakaki , Yiannis Dimitriadis , Grace Mountain , Robert Hughes , Sherneca Clarke-Melville , Alexander Roediger , Kostas Athanasakis

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引用次数: 0

摘要

背景：Anti-PD-(L)1s是一类新的免疫疗法，已被发现可改善多种肿瘤的健康结果。尽管免疫肿瘤治疗（IOs）自2015年以来在希腊已经可用，但它们的扩大使用可能被认为是医疗系统负担能力的挑战。健康影响预测（HIP）模型旨在评估在癌症治疗中使用抗pd -(L)1抑制剂对健康和经济的影响。方法：HIP比较了有抗pd -(L)1s的世界和没有抗pd -(L)1s的世界，其中患者接受既往标准护理（SoC）治疗。该模型评估临床结果（生命年、无进展/无复发生存（PFS/RFS）年、获得的质量调整生命年（QALYs））和经济影响（直接和间接成本）。HIP分析了5年（2021-2025年）的患者队列和7种癌症适应症：早期高危黑色素瘤，转移性黑色素瘤，一线转移性非小细胞肺癌（1L mNSCLC），局部晚期，不可切除（III期）NSCLC，二线（2L）转移性尿路上皮癌含铂化疗后，1L晚期肾细胞癌和1L/2L复发/转移性鳞状细胞头颈癌。模型输入基于公开可用的数据、文献综述和当地专家的输入。结果：在5年的时间里，估计有21,067名新癌症患者可以接受抗pd -(L) 15治疗，从而获得9,848年的额外生命年（与SoC相比增加34%），9,632年的PFS/RFS年（增加70%）和8,409年的QALYs（增加40%）。此外，在5年的时间范围内，这些寿命年将继续呈上升趋势，而相应的平均经济影响（2.02亿欧元/年）将在2025年达到平稳期。使用抗pd -(L)1s可显著降低间接成本（2.6亿欧元），帮助患者每年额外工作900万小时，而抗pd -(L)1s的额外支出占医疗总支出（2021年）的1.2%。结论：抗pd -(L)1s在希腊癌症治疗中的引入与癌症患者的显著健康益处相关，并具有可控的经济影响。政策摘要：证据支持在希腊投资IO治疗并确保肿瘤患者可持续获得治疗。

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Assessing the impact of anti-PD-1/PD-L1 inhibitors on cancer care health and budget in Greece

Background

Anti-PD-(L)1s, a new immunotherapy class, has been found to improve health outcomes in a wide range of tumours. Although immune-oncologic treatments (IOs) have been available since 2015 in Greece, their expanding use might be considered challenging for healthcare systems' affordability. The Health Impact Projection (HIP) model is designed to estimate the health and economic impact of using anti-PD-(L)1 inhibitors in cancer treatment.

Methods

HIP compares a world withanti-PD-(L)1s versus a world without, where patients are treated with previous standard-of-care (SoC). The model assesses clinical outcomes (life years, progression/recurrence-free survival [PFS/RFS]years, quality-adjusted life-years[QALYs] gained) and economic impact (direct & indirect costs). HIP analyses patient cohorts across a 5-year horizon(2021–2025) and 7 cancer indications: early-stage high-risk melanoma, metastatic melanoma, first-line metastatic non-small-cell lung cancer (1L mNSCLC), locally advanced, unresectable(stage III) NSCLC, second-line(2L) metastatic urothelial carcinoma after platinum-containing chemotherapy, 1L advanced renal cell carcinoma and 1L/2L recurrent/metastatic squamous cell head&neck cancer. Model inputs were based on publicly available data, literature review and local experts’ input.

Results

Over a 5-year time period, it is estimated that 21,067 new cancer patients could be treated with anti-PD-(L)1s resulting in 9848 additional life years (+34 % vs SoC), 9632 PFS/RFS years (+70 %), and 8409 QALYs (+40 %) gained. Furthermore, these life years gained continue on an upward trend beyond the 5-year time horizon, while the respective average economic impact (€202million/year) reaches a plateau by 2025. Use of anti-PD-(L)1s could lead to a significant reduction in indirect (€260million) costs, helping patients work an additional 9million hours/year, while the additional expenditure for anti-PD-(L)1s represents 1.2 % of the total healthcare expenditure (2021).

Conclusion

Anti-PD-(L)1s’ introduction in cancer care is associated with significant health benefits for cancer patients in Greece with manageable economic impact.