Cost-effectiveness of treatment sequences for BRAF-mutant advanced melanoma in the Netherlands using a health economic model

被引：0

作者：

Blommestein, Hedwig M. ^{[1
]}

de Groot, Saskia ^{[2
]}

Leeneman, Brenda ^{[2
]}

Uyl-de Groot, Carin A. ^{[2
]}

Haanen, John B. A. G. ^{[3
]}

Wouters, Michel W. J. M. ^{[4
,5
,6
]}

Aarts, Maureen J. B. ^{[7
]}

van den Berkmortel, Franchette W. P. J. ^{[8
]}

Blokx, Willeke A. M. ^{[9
]}

Boers-Sonderen, Marye J. ^{[10
]}

van den Eertwegh, Alfons J. M. ^{[11
]}

de Groot, Jan Willem B. ^{[12
]}

Hospers, Geke A. P. ^{[13
]}

Kapiteijn, Ellen ^{[14
]}

van Not, Olivier J. ^{[4
,15
]}

Veldt, Astrid A. M. van der ^{[16
]}

Suijkerbuijk, Karijn P. M. ^{[15
]}

Franken, Margreet G. ^{[1
,2
]}

机构：

[1] Erasmus Univ, Erasmus Sch Hlth Policy & Management, Burgemeester Oudlaan 50, NL-3062 PA Rotterdam, Netherlands

[2] Erasmus Univ, Inst Med Technol Assessment, Rotterdam, Netherlands

[3] Netherlands Canc Inst, Div Med Oncol, Amsterdam, Netherlands

[4] Dutch Inst Clin Auditing, Sci Bur, Leiden, Netherlands

[5] Netherlands Canc Inst Antoni Van Leeuwenhoek, Dept Surg Oncol, Amsterdam, Netherlands

[6] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Leiden, Netherlands

[7] Maastricht Univ, Dept Radiol & Nucl Med, Grow Sch Oncol & Dev Biol, Med Ctr, Maastricht, Netherlands

[8] Zuyderland Med Ctr, Dept Med Oncol, Sittard Geleen, Netherlands

[9] Univ Med Ctr Utrecht, Dept Pathol, Div Labs Pharm & Biomed Genet, Utrecht, Netherlands

[10] Radboud Univ Nijmegen, Med Ctr, Dept Med Oncol, Nijmegen, Netherlands

[11] Vrije Univ Amsterdam, Canc Ctr Amsterdam, Dept Med Oncol, Amsterdam UMC,Med Ctr, Amsterdam, Netherlands

[12] Isala Oncol Ctr, Zwolle, Netherlands

[13] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[14] Leiden Univ, Med Ctr, Dept Med Oncol, Leiden, Netherlands

[15] Univ Med Ctr Utrecht, Dept Med Oncol, Utrecht, Netherlands

[16] Erasmus Univ, Med Ctr, NL-3015CE Rotterdam, Netherlands

来源：

EUROPEAN JOURNAL OF CANCER | 2025年 / 218卷

关键词：

Cost-Effectiveness Analysis; Quality-Adjusted Life Years; Drug Costs; Melanoma; Proto-Oncogene Proteins B-raf; Immunotherapy; Nivolumab; Ipilimumab; Binimetinib; Encorafenib; METASTATIC MELANOMA;

D O I：

10.1016/j.ejca.2024.115071

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: This study aims to evaluate the cost-effectiveness of treatment sequences for patients with advanced melanoma with a BRAF mutation in the Netherlands from a societal perspective. Methods: A semi-Markov model with a life-time horizon has been used to evaluate cost-effectiveness of 21 treatment sequences. Real-world data from the Dutch Melanoma Treatment Registry (DMTR) were used to estimate time to progression, next treatment and death. Utilities by health state as well as hospital costs, health care costs outside the hospital, patient and family costs and productivity costs were also derived from the DMTR. Drug costs were estimated based on the recommended dose and duration of treatment. Incremental costeffectiveness ratios (ICERs) were presented as incremental costs per QALY gained. Results: Health benefits of treatment sequences consisting of targeted therapies and immunotherapies vary between 2.3 and 5.8 QALYs gained per patient when compared to chemotherapy. The increase in costs varies between <euro>112,000 and <euro>383,000. The efficiency frontier consists of nivolumab in the first line followed by ipilimumab in the second line (ICERs of <euro>42,000/QALY and <euro>44,000/QALY), nivolumab in the first line followed by encorafenib plus binimetinib in the second line (ICERs of <euro>71,000/QALY and <euro>68,000/QALY) and nivolumab plus ipilimumab in the first line followed by encorafenib plus binimetinib in the second line (ICERs of <euro>74,000/ QALY and <euro>76,000/QALY). The first treatment given within a sequence as well as assumptions regarding treatment duration have a substantial impact on cost-effectiveness outcomes. Conclusion: The ICERs can be considered cost-effective at different cost-effectiveness thresholds.

引用

页数：13

共 23 条

[21] Zorginstituut Nederland, Farmacotherapeutisch Kompas Geneesmiddelen
[22] Zorginstituut Nederland, 2018, Ziektelast in de praktijk-De theorie en praktijk van het berekenen van ziektelast bij pakketbeoordelingen-Rapport-Zorginstituut Nederland
[23] Zorginstituut Nederland W., 2015, Kosteneffectiviteit in de praktijk-Rapport-Zorginstituut Nederland

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