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首页> 外文期刊>Cost Effectiveness Resource Allocation >Cost-effectiveness analysis of pembrolizumab compared to standard of care as first line treatment for patients with advanced melanoma in Hong Kong
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Cost-effectiveness analysis of pembrolizumab compared to standard of care as first line treatment for patients with advanced melanoma in Hong Kong

机译：与香港晚期黑素瘤患者的护理标准与护理标准相比，Pembrolizumab的成本效果分析

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Background:Pembrolizumab has been shown to improve overall survival (OS) and progression free survival (PFS) compared to ipilimumab in patients with ipilimumab-na?ve advanced melanoma; however, there are no published data on the cost-effectiveness for pembrolizumab compared to standard-of-care treatments currently used in Hong Kong for advanced melanoma.Methods:A partitioned-survival model based on data from a recent randomized phase 3 study (KEYNOTE-006) and meta-analysis was used to derive time in PFS, OS, and post-progression survival for pembrolizumab and chemotherapy, such as dacarbazine (DTIC), temozolomide (TMZ), and the paclitaxel-carboplatin combination (PC). A combination of clinical trial data, published data, results of meta-analysis, and melanoma registry data was used to extrapolate PFS and OS curves. The base-case time horizon for the model was 30?years with costs and health outcomes discounted at a rate of 5% per year. Individual patient level data on utilities and frequencies of adverse events were obtained from the final analysis of KEYNOTE-006 (cut-off date: 3-Dec-15) for pembrolizumab. Cost data included drug acquisition, treatment administration, adverse event management, and clinical management of advanced melanoma. The distribution of patient weight from the Hong Kong population was applied to calculate the drug costs. Analyses were performed from a payer's perspective. The incremental cost effectiveness ratio (ICER) expressed as cost in US Dollars (USD) per quality-adjusted life years (QALYs) was the main outcome.Results:In base-case scenario, the ICER for pembrolizumab as a first-line treatment for advanced melanoma was USD49,232 compared to DTIC, with the ICER values lower than cost-effectiveness threshold in Hong Kong. Results comparing pembrolizumab to TMZ and to PC were similar to that when compared to DTIC. Probability sensitivity analyses showed that 99% of the simulated ICERs were below three times the Gross Domestic Product (GDP) per capita for Hong Kong (currently at $119,274//QALY threshold). In a scenario analysis comparing pembrolizumab with ipilimumab, the estimated ICER was USD8,904.Conclusions:Pembrolizumab is cost-effective relative to chemotherapy (DTIC, TMZ and PC), and highly-cost-effective compared to ipilimumab, for the first-line treatment of advanced melanoma in Hong Kong.? The Author(s) 2020.
机译：背景：与IPILIMIMAB-NA'VE先进的黑色素瘤患者的IPILIMIMAB相比，PEMBROLIZUMAB已被证明可以改善整体存活（OS）和进展免费存活（PFS）;然而，与目前在香港的高级黑素瘤使用的护理标准治疗方法没有公布的数据有关Pembrolizumab的成本效益。方法：基于来自最近的随机第3阶段研究的数据的分区生存模型（主题演讲-006）和Meta分析用于导出PEMBROLIZUMAB和化疗的PFS，OS和进展后生存期的时间，例如达酰鸟（DTIC），替氏毒物（TMZ）和紫杉醇 - 卡铂组合（PC）。临床试验数据的组合，公布数据，元分析结果和黑素瘤注册表数据用于推断PFS和OS曲线。该模型的基本情况时间范围为30岁以下的成本和健康成果，每年折扣为5％。关于彭洛洛洛妥妥的末端 - 006（截止日期：3-1215）的最终分析，获得了关于不良事件的特性和频率的个体患者水平数据。成本数据包括药物采集，治疗局，不良事件管理和晚期黑素瘤的临床管理。从香港人口分布患者重量的分布是计算药物成本。分析来自付款人的角度。按照每年质量调整的生命年份（QALYS）以美元（美元）的成本表示的增量成本效益率（QALYS）是主要的结果。结果：在基本情况下，Pembrolizumab的ISER作为一线治疗与DTIC相比，先进的黑素瘤是49,232美元，其转向价值低于香港的成本效益阈值。结果与DTIC相比，Pembrozumab与TMZ和PC的结果相似。概率敏感性分析表明，99％的模拟嫌股公司低于香港国内生产总值（GDP）的三倍（目前为119,274美元// QALY门槛）。在与IPILIMIMAB进行比较的情况下，估计的算术是USD8,904。结论：Pembrolizumab相对于化疗（DTIC，TMZ和PC）具有成本效益，以及与IPILIMIMAB相比的高度成本效益香港晚期黑素瘤治疗。作者2020年。

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