OBJECTIVES:To estimate the cost-effectiveness of bortezomib (BTZ) compared with dexamethasone (DEX) and lenalidomide plus dexamethasone (LEN/DEX) for the treatment of relapsed/refractory multiple myeloma in Sweden. METHODS:We used partitioned survival analysis to assess survival data decomposed into three states: (i) alive before disease progression; (ii) alive after progression; and (iii) dead. The effects of treatment on time to progression and overall survival (OS) were obtained from published reports of the APEX, MM-009, and MM-010 randomized clinical trials. Costs included drug and administration costs, adverse events, treatment of relapses, and end-of-life costs. Utility estimates were derived from the literature. RESULTS:BTZ mean OS was 57.4 months compared with 44.6 and 54.1 months for DEX and LEN/DEX, respectively. Mean lifetime direct medical costs per patient were approximately 2010 SEK 1,904,462, 1,278,854, and 2,450,588 for BTZ, DEX, and LEN/DEX, respectively. Mean incremental cost per quality-adjusted life-year of BTZ compared to DEX was 2010 SEK 902,874 (€95,073) (95% CI: 514,791, 962,416) and was dominant with respect to LEN/DEX. CONCLUSION:BTZ and LEN/DEX are projected to prolong survival relative to DEX. From a Swedish perspective, BTZ is cost-effective compared to DEX and LEN/DEX.

译文

目的:评估硼替佐米(BTZ)与地塞米松(DEX)和来那度胺加地塞米松(LEN / DEX)在瑞典治疗复发/难治性多发性骨髓瘤的成本效益。
方法:我们使用分区生存分析来评估分解成三个状态的生存数据:(i)在疾病进展之前还活着; (ii)进展后还活着; (iii)死亡。从APEX,MM-009和MM-010随机临床试验的已发表报告中可以获得治疗对进展时间和总生存期(OS)的影响。费用包括药品和管理费用,不良事件,复发治疗和生命周期终止费用。效用估计值是从文献中得出的。
结果:BTZ平均OS为57.4个月,而DEX和LEN / DEX分别为44.6和54.1个月。对于BTZ,DEX和LEN / DEX,每位患者的平均终生直接医疗费用分别约为2010 SEK 1,904,462、1,278,854和2,450,588。与DEX相比,BTZ每质量调整生命年的平均增量成本为902,874瑞典克朗(95,073欧元)(95%CI:514,791,962,416),并且在LEN / DEX方面占主导地位。
结论:相对于DEX,BTZ和LEN / DEX有望延长生存期。从瑞典的角度来看,与DEX和LEN / DEX相比,BTZ具有成本效益。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录