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Economic Evaluation of First-Line Treatments for Metastatic Renal Cell Carcinoma A Cost-Effectiveness Analysis in A Health Resource–Limited Setting 英文参考文献.docVIP

Economic Evaluation of First-Line Treatments for Metastatic Renal Cell Carcinoma A Cost-Effectiveness Analysis in A Health Resource–Limited Setting 英文参考文献.doc

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Economic Evaluation of First-Line Treatments for Metastatic Renal Cell Carcinoma A Cost-Effectiveness Analysis in A Health Resource–Limited Setting 英文参考文献

EconomicEvaluationofFirst-LineTreatmentsfor MetastaticRenalCellCarcinoma:ACost-Effectiveness AnalysisinAHealthResource–LimitedSetting BinWu1,BaijunDong2,YuejuanXu3,QiangZhang4,JinfangShen1,HuafengChen1,WeiXue2* 1Clinical Outcomes and Economics Group, Department of pharmacy, Renji Hospital, affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, People’sRepublicofChina,2DepartmentofUrology,RenjiHospital,affiliatedwiththeSchoolofMedicine,ShanghaiJiaotongUniversity,Shanghai,People’sRepublicof China,3DepartmentofOncology,theSecondHospitalofNanjing,affiliatedtoMedicalSchoolofSouthEastUniversity,Nanjing,People’sRepublicofChina,4Department ofOncology,ShanghaiPutuoHospital,ShanghaiUniversityofTraditionalChineseMedicine,Shanghai,People’sRepublicofChina Abstract Background:Toestimate,fromtheperspectiveoftheChinesehealthcaresystem,theeconomicoutcomesoffivedifferent first-linestrategiesamongpatientswithmetastaticrenalcellcarcinoma(mRCC). MethodsandFindings:Adecision-analyticmodelwasdevelopedtosimulatethelifetimediseasecourseassociatedwith renal cell carcinoma. The health and economic outcomes of five first-line strategies (interferon-alfa, interleukin-2, interleukin-2plusinterferon-alfa,sunitinibandbevacizumabplusinterferon-alfa)wereestimatedandassessedbyindirect comparison.Theclinicalandutilitydataweretakenfrompublishedstudies.Thecostdatawereestimatedfromlocalcharge data and current Chinese practices. Sensitivity analyses were used to explore the impact of uncertainty regarding the results. The impact of the sunitinib patient assistant program (SPAP) was evaluated via scenario analysis. The base-case analysisshowedthatthesunitinibstrategyyieldedthemaximumhealthbenefits:2.71lifeyearsand1.40quality-adjusted life-years(QALY).Themarginalcost-effectiveness(costperadditionalQALY)gainedviathesunitinibstrategycomparedwith theconventionalstrategywas$220,384(withoutSPAP,interleukin-2plusinterferon-alfaandbevacizumabplusinterferon- alfa were dominated) and $16,993

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