意大利早期非小细胞肺癌使用Atezolizumab预防复发的成本估算模型

IF 2.7 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Andrea Marcellusi, Marco Belfiore, Rosaria Tempre, Maria Buonfiglio, Alessandro Russo
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引用次数: 0

摘要

背景:早期非小细胞肺癌(eNSCLC)患者在手术和辅助化疗后经常出现疾病复发,给患者带来了巨大的临床和经济负担。在辅助治疗中引入免疫疗法,如atezolizumab,可以通过预防疾病进展提供临床益处和医疗成本降低。目的:本分析旨在通过测量意大利潜在符合atezolizumab辅助治疗条件的人群中避免的成本来估计预防复发的经济影响。方法:使用已发表的模型进行成本-后果分析,适应意大利的情况,以估计2023年至2033年每年的复发数量,比较“使用”和“不使用”atezolizumab的情况。流行病学和临床资料来自已发表的文献、临床试验和当地市场调查。直接医疗费用来源于意大利的一项真实世界研究。考虑了意大利国家卫生系统(NHS)的观点,并进行了确定性的单向敏感性分析,以评估主要参数的不确定性。结果:在研究期间,每年估计有2582例切除和化疗后II-IIIA期eNSCLC(第7版TNM[肿瘤、淋巴结、转移]分类)患者。根据已批准的适应症,其中720例(27.9%)可能有资格接受atezolizumab治疗。总体而言,该模型估计符合条件的患者有2556例复发,每年产生1102万欧元的经济负担。引入atezolizumab可避免720例复发(111例局部区域复发,609例转移性复发),从意大利NHS的角度来看,每年可直接减少311万欧元的医疗成本。单向敏感性分析显示,在转移性情况下,特别是由于药物成本的影响,基本病例发生了适度变化。结论:复发在eNSCLC患者中很常见,并且与总直接成本的显著增加相关。从意大利NHS的角度来看,辅助atezolizumab似乎可以预防相关数量的事件,并可能节省与复发相关的费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-Estimation Model of Prevented Recurrences with Atezolizumab in Early Non-Small-Cell Lung Cancer in Italy.

Background: Patients with early-stage non-small-cell lung cancer (eNSCLC) often experience disease recurrence after surgery and adjuvant chemotherapy, leading to a substantial clinical and economic burden. The introduction of immunotherapy such as atezolizumab in the adjuvant setting may offer both clinical benefits and healthcare cost reductions by preventing disease progression.

Objectives: This analysis aimed to estimate the economic impact of prevented recurrences by measuring the costs avoided in the Italian population potentially eligible for adjuvant atezolizumab.

Methods: A cost-consequence analysis was developed using a published model, adapted to the Italian context, to estimate the number of recurrences per year from 2023 to 2033, comparing scenarios 'with' and 'without' atezolizumab. Epidemiological and clinical input was obtained from published literature, clinical trials, and local market research. Direct healthcare costs were sourced from an Italian real-world study. The Italian national health system (NHS) perspective was considered, and a deterministic one-way sensitivity analysis was performed to evaluate the uncertainty over the main parameters.

Results: Over the period considered, 2582 patients with stage II-IIIA eNSCLC (7th edition of the TNM [tumour, node, metastases] classification) after resection and chemotherapy were estimated annually. Of these, 720 (27.9%) were potentially eligible to receive atezolizumab according to the approved indication. Overall, the model estimated 2556 recurrences for the eligible patients, which generated an economic burden of €11.02 million yearly. The introduction of atezolizumab could avoid 720 recurrences (111 locoregional and 609 metastatic), resulting in a direct healthcare cost reduction of €3.11 million annually from the perspective of the Italian NHS. One-way sensitivity analysis showed moderate base-case changes, especially due to drug costs in the metastatic settings.

Conclusions: Recurrences are common among patients with eNSCLC and are associated with a remarkable increase in total direct costs. It appears that adjuvant atezolizumab would prevent a relevant number of events, with potential savings in recurrence-related costs from the perspective of the NHS in Italy.

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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional 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 Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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