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首页> 美国卫生研究院文献>Sarcoma >Cost Effectiveness of First-Line Treatment with Doxorubicin/Ifosfamide Compared to Trabectedin Monotherapy in the Management of Advanced Soft Tissue Sarcoma in Italy Spain and Sweden
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Cost Effectiveness of First-Line Treatment with Doxorubicin/Ifosfamide Compared to Trabectedin Monotherapy in the Management of Advanced Soft Tissue Sarcoma in Italy Spain and Sweden

机译：在意大利西班牙和瑞典使用阿霉素/异环磷酰胺一线治疗与曲贝汀单药治疗晚期软组织肉瘤的成本效益比较

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Background. Doxorubicin/ifosfamide is a first-line systemic chemotherapy for the majority of advanced soft tissue sarcoma (ASTS) subtypes. Trabectedin is indicated for the treatment of ASTS after failure of anthracyclines and/or ifosfamide; however it is being increasingly used off-label as a first-line treatment. This study estimated the cost effectiveness of these two treatments in the first-line management of ASTS in Italy, Spain, and Sweden. Methods. A Markov model was constructed to estimate the cost effectiveness of doxorubicin/ifosfamide compared to trabectedin monotherapy, defined as the cost per QALY gained, in each country. Results. First-line treatment with doxorubicin/ifosfamide resulted in lower two-year healthcare costs and more QALYs than first-line treatment with trabectedin monotherapy in all three countries. Probabilistic sensitivity analysis showed that at a cost per QALY threshold of €35,000, >90% of a cohort would be cost effectively treated with doxorubicin/ifosfamide compared to trabectedin monotherapy in all three countries. Conclusion. Within the model's limitations, first-line treatment of patients with ASTS with doxorubicin/ifosfamide instead of trabectedin monotherapy affords a cost-effective use of publicly funded healthcare resources in Italy, Spain, and Sweden and is therefore the preferred treatment in all three countries. These findings support the recommendation that trabectedin should remain a second-line treatment.
机译：背景。阿霉素/异环磷酰胺是一类针对大多数晚期软组织肉瘤（ASTS）亚型的一线系统化疗。蒽环类药物和/或异环磷酰胺治疗失败后，曲贝汀可用于治疗ASTS。但是，越来越多的人将它作为一线治疗药物而使用。这项研究估计了这两种疗法在意大利，西班牙和瑞典的ASTS一线管理中的成本效益。方法。建立了一个马尔可夫模型，以评估阿霉素/异环磷酰胺与trabectedin单一疗法相比在每个国家中的成本效果，后者定义为每获得QALY的成本。结果。在所有三个国家中，与阿霉素单药一线治疗相比，阿霉素/异环磷酰胺一线治疗可降低两年的医疗保健成本，并带来更多的QALY。概率敏感性分析显示，在所有这三个国家中，与特拉贝丁单一疗法相比，阿霉素/异环磷酰胺治疗的每个队列的QALY阈值费用为35,000欧元，可以有效地治疗超过90％的队列。结论。在该模型的限制范围内，用阿霉素/异环磷酰胺代替曲贝汀单一疗法对ASTS患者进行一线治疗可有效利用意大利，西班牙和瑞典的公共资助医疗资源，因此是所有三个国家的首选治疗方法。这些发现支持了trabectedin应继续作为二线治疗的建议。

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