意大利威尼托地区使用舒尼替尼和索拉非尼治疗转移性肾细胞癌的经济影响

S. Ballali, D. Chiffi, M. Trojniak, D. Gregori
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引用次数: 1

摘要

目的:评估多靶点酪氨酸激酶抑制剂(TKI)在Veneto地区符合条件的患者中考虑一线和二线治疗的影响,为期3年。方法:采用马尔可夫状态决策模型,考虑三种不同状态的转移概率,比较治疗组和未治疗组的预期死亡和月生存率,对威尼托公立医院使用舒尼替尼和索拉非尼三年的成本影响进行评估。结果:从357例符合舒尼替尼治疗条件的初始队列中,考虑了稳定的患者(139例),以评估多靶点药物对疾病总体进展的影响。结果显示,与未接受舒尼替尼治疗的患者相比,接受舒尼替尼治疗的患者从稳定状态过渡到进展状态的比例较小。舒尼替尼治疗6个月的费用中位数为2532666美元,12个月时累计费用增加至3607807美元。由于向死亡或二线治疗过渡,第一年之后的费用持平在同一数字(380万欧元)左右。讨论:前6个月舒尼替尼治疗的费用对威尼托地区的公共卫生费用有非常高的影响,而索拉非尼二线治疗增加的总费用比例较小,因为接受这种治疗的患者比例较小,而且药物的成本相对较低。结论:从我们对SSN承担的mRCC患者治疗费用的模拟模型得出的结论,我们可以得出结论,SSN对疾病的进展是有效的,最大的影响是一线药物治疗的成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Economic Impact of Sunitinib and Sorafenib Use in Metastatic Renal Cell Carcinoma Treatment in Veneto Region, Italy
Objective: To evaluate the impact of multitargeted tyrosine kinase inhibitors (TKI) considering 1 st and 2 nd line treatment for a full period of 3 years in the eligible patients of Veneto Region. Methods: A Markov state decision model was selected to evaluate the cost impact of sunitinib and sorafenib use for a lapse of time of three years in Veneto public hospitals, considering transition probabilities from three different states and by comparing the expected deaths and the monthly survival rates in treatment and no-treatment groups. Results: From the initial cohort of 357 patients eligible for sunitinib treatment, stable ones (139) were considered in order to evaluate the impact of the multitargeted agent on overall progression of the disease. Results showed that a smaller portion of patients receiving sunitinib transited from a stable to a progressive state, with respect to the patients who were not receiving sunitinib. The cost of 6 months treatment with sunitinib reached a median value of 2532666� , increasing till 3607807� as cumulative amount at 12 months. Costs after the 1 st year flattened around the same figure (3800000� ) due to the transition towards death or 2 nd line treatments. Discussion: the costs of the first 6 months therapy with sunitinib have a very high impact on public health expenses in the Regione Veneto. 2 nd line treatment with sorafenib instead increased overall expenses of a reduced proportion, due to the small proportion of patients undergoing this treatment and the relative inferior cost of the drug. Conclusion: From what came out from our simulated model on costs borne by the SSN for the treatment of patients with mRCC, we can conclude that they are effective on the progression of the disease the greatest impact being the cost for the 1 st line pharmacological treatment.
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