基于真实世界数据分析马来酸吡咯替尼治疗HER-2阳性转移性乳腺癌的有效性及经济性
Efficacy and pharmacoeconomic evaluations of pyrotinib in the treatment of HER-2 positive metastatic breast cancer based upon real world data
耿亚迪 1刘含韵 2吴颖其 1颜辉 1余翠翠 1宁丽娟 1朱鹏里 1陈泳伍 1吴菲 1沈爱宗1
作者信息
- 1. 中国科学技术大学附属第一医院(安徽省立医院)药学部,安徽合肥 230001;安徽省药品临床综合评价技术中心,安徽合肥 230001
- 2. 中国科学技术大学管理学院,安徽合肥 230001
- 折叠
摘要
目的:分析吡咯替尼对比拉帕替尼分别联合其他抗肿瘤药物治疗人表皮生长因子受体-2(HER-2)阳性转移性乳腺癌的有效性及经济性.方法:回顾性纳入中国科学技术大学附属第一医院(安徽省立医院)2018年1月至2023年1月使用拉帕替尼(对照组)或吡咯替尼(观察组)的HER-2阳性转移性乳腺癌患者,收集患者基本信息、临床疗效及住院成本信息.比较2组的无进展生存期(PFS)、有效率(RR)及疾病控制率(DCR),并以PFS为产出指标,计算增量成本效果比(ICER).结果:2组患者的年龄、病理类型、病理分期及治疗方案均无显著性差异,效果方面,两组的PFS分别为3.16个月(拉帕替尼组)及6.67个月(吡咯替尼组)(P＜0.05);2组RR及DCR均无显著性差异;成本方面,2组的平均总住院成本分别为78 500.51元(拉帕替尼组)及144 094.66元(吡咯替尼组);吡咯替尼组对比拉帕替尼组的ICER为18 687.79元/月.单因素敏感性分析表明,吡咯替尼组住院费用对结果的影响较大;概率敏感性结果表明,当意愿支付阈值(WTP)为32 600元/月时,吡咯替尼组和拉帕替尼组具有经济性的概率各为50％.结论:吡咯替尼组的治疗效果优于拉帕替尼组,成本效果分析结果表明,当患者的WTP大于18 687.79元/月时,吡咯替尼更具有经济性.
Abstract
OBJECTIVE To explore the efficacies and economics of pyrotinib versus lapatinib plus other anti-tumor agents for HER-2(human epidermal growth factor receptor-2)positive metastatic breast cancer.METHODS From January 2018 to January 2023,HER-2 positive patients of advanced breast cancer on a therapy of lapatinib or pyrotinib at First Affiliated Hospital of USTC were retrospectively reviewed.They were assigned into two groups of lapatinib and pyrotinib.Basic profiles,clinical outcomes and hospitalization expense were recorded.Progression-free survival(PFS),response rate(RR)and disease control rate(DCR)of two groups were compared.And PFS was utilized as an output index for calculating the value of incremental cost-effectiveness ratio(ICER).RESULTS No significant inter-group differences existed in age,pathological type,pathological stage or treatment regimen.The median PFS of two groups was 3.16 months in lapatinib group and 6.67 months in pyrotinib group(P＜0.05).No significant inter-group difference existed in RR or DCR.Mean total hospitalization expenses were 78 500.51 yuan(lapatinib group)and 144 094.66 yuan(pyrotinib group)respectively.ICER of pyrotinib versus lapatinib was 18 687.79 yuan per month.One-way Sensitivity analysis revealed that hospitalization expense had a greater impact on the results in pyrotinib group.Probabilistic sensitivity analysis indicated that,at a threshold of willingness-to-pay(WTP)＞32 600 yuan/month,the probability of cost-effective of pyrotinib group and lapatinib group was 50％ each.CONCLUSION The treatment efficacy of pyrotinib group is better than that of lapatinib group.Cost-effectiveness analysis revealed that when WTP is greater than 18 687.79 yuan/month,pyrotinib is a cost-effective alternative therapy for HER-2 positive metastatic breast cancer.
关键词
吡咯替尼/拉帕替尼/乳腺癌/真实世界/无进展生存期/成本效果分析Key words
pyrotinib/lapatinib/breast cancer/real world data/PFS/cost-effectiveness analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据