Atezolizumab Plus Chemotherapy vs. Chemotherapy in Advanced or Metastatic Triple-Negative Breast Cancer: A Cost-Effectiveness Analysis.

IF 3 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Frontiers in Public Health Pub Date : 2021-10-29 eCollection Date: 2021-01-01 DOI:10.3389/fpubh.2021.756899

Xiaoyan Liu, Yitian Lang, Yahui Liao, Yizhun Zhu

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引用次数: 4

Abstract

Purpose: The IMpassion130 trial demonstrated the efficacy of adding atezolizumab to paclitaxel for advanced or metastatic triple-negative breast cancer (TNBC). The current study evaluated the cost-effectiveness of adding atezolizumab to nab-paclitaxel for TNBC from the perspective of Chinese health sector. Methods: A partitioned survival model was implemented for patients with TNBC. The survival data were derived from IMpassion130 trial. Direct costs and utility values were collected from the Chinese Drug Bidding Database and published literatures. The primary analysis outcomes were quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to observe model stability. Results: In the base-case analysis, the ICER of atezolizumab plus nab-paclitaxel vs. nab-paclitaxel is respectively, $176,056/QALY, $118,146/QALY, and $323,077/QALY in the ITT, PD-L1(+) and PD-L1(-) group. Conclusion: Adding atezolizumab to nab-paclitaxel could improve survival time significantly in the PD-L1-positive group, but it is not a cost-effective strategy compared to nab-paclitaxel monotherapy for Chinese patients with advanced or metastatic triple-negative breast cancer in the current economic context of China.

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Atezolizumab加化疗vs化疗治疗晚期或转移性三阴性乳腺癌:成本-效果分析

目的:IMpassion130试验证明了将atezolizumab加入紫杉醇治疗晚期或转移性三阴性乳腺癌(TNBC)的疗效。本研究从中国卫生部门的角度评估了在nab-紫杉醇中加入atezolizumab治疗TNBC的成本效益。方法:采用三阴癌患者分区生存模型。生存数据来源于IMpassion130试验。直接成本和效用值来源于中国药品招标数据库和已发表的文献。主要分析结果为质量调整生命年(QALYs)和增量成本-效果比(ICERs)。通过敏感性分析观察模型的稳定性。结果:在基础病例分析中，ITT、PD-L1(+)和PD-L1(-)组atezolizumab联合nab-紫杉醇与nab-紫杉醇的ICER分别为176056美元/QALY、118146美元/QALY和323077美元/QALY。结论:在中国目前的经济背景下，对于晚期或转移性三阴性乳腺癌患者，在nab-紫杉醇组中加入atezolizumab可以显著提高pd - l1阳性组的生存时间，但与nab-紫杉醇单药治疗相比，这不是一种具有成本效益的策略。

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来源期刊

Frontiers in Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

7.70%

发文量

4469

审稿时长

14 weeks

期刊介绍： Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice. Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.