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Tính Hiệu Quả Chi Phí Của Axicabtagene Ciloleucel So Với Chăm Sóc Hỗ Trợ Tốt Nhất Trong Việc Điều Trị Bệnh Nhân Người Lớn Bị U Lympho B Cell Lớn Tái Phát Hoặc Chống Chịu Sau Hai Hoặc Hơn Hai Đợt Điều Trị Hệ Thống Tại Canada
Tóm tắt
Axicabtagene ciloleucel (axi-cel) đã nhận được sự cấp phép tiếp thị tại Canada cho việc điều trị u lympho B cell lớn tái phát hoặc kháng trị sau hai hoặc nhiều hơn hai đợt điều trị hệ thống. Giá trị lâm sàng và kinh tế của axi-cel đối với bệnh nhân và hệ thống y tế nên được xem xét. Mục tiêu của phân tích này là xác định, từ quan điểm của xã hội và người chi trả y tế công cộng, tính hiệu quả chi phí của axi-cel so với chăm sóc hỗ trợ tốt nhất cho bệnh nhân mắc u lympho B cell lớn tái phát hoặc kháng trị tại Canada. Một mô hình kinh tế dược phẩm đã được phát triển và tìm kiếm dữ liệu lâm sàng từ các nghiên cứu ZUMA-1 và SCHOLAR-1 bằng cách sử dụng so sánh ghép cặp theo điểm xu hướng. Một cách tiếp cận mô hình hỗn hợp phân đoạn sống sót đã được áp dụng để mô tả hiệu ứng tiềm năng chữa trị của phương pháp điều trị axi-cel trong u lympho B cell lớn. Việc sử dụng tài nguyên y tế và dữ liệu sự kiện bất lợi dựa trên kết quả từ ZUMA-1, và giá trị tiện ích lấy từ dữ liệu ZUMA-1 được bổ sung bởi tài liệu đã công bố. Chi phí (tính bằng đô la Canada năm 2021) được lấy từ các cơ sở dữ liệu chi phí công khai của Canada và tài liệu đã công bố. Lợi ích và chi phí được chiết khấu ở mức 1,5% mỗi năm, và các phân tích độ nhạy đã được thực hiện để đánh giá độ chắc chắn của các kết quả. Trong trường hợp cơ bản, axi-cel đã tạo ra thêm 6,2 năm sống so với chăm sóc hỗ trợ tốt nhất, tương đương với 4,6 năm sống điều chỉnh theo chất lượng bổ sung, và có liên quan đến chi phí bổ sung là 606,010 đô la. Tỉ lệ chi phí-lợi ích gia tăng là 132,747 đô la cho mỗi năm sống điều chỉnh theo chất lượng so với chăm sóc hỗ trợ tốt nhất từ góc độ xã hội (106,392 đô la cho mỗi năm sống điều chỉnh theo chất lượng từ góc độ người chi trả y tế công cộng). Những yếu tố chính của phân tích bao gồm giá trị sống không tiến triển và sống toàn bộ cho axi-cel. Các kết quả của phân tích này gợi ý rằng axi-cel có thể được coi là phân bổ tài nguyên hiệu quả về chi phí so với chăm sóc hỗ trợ tốt nhất trong việc điều trị bệnh nhân lớn tuổi bị u lympho B cell lớn tái phát hoặc kháng trị tại Canada.
Từ khóa
#Axicabtagene ciloleucel #u lympho B cell lớn #chi phí #hiệu quả chi phí #điều trị #CanadaTài liệu tham khảo
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