PDF(Pubmed)
Abstract：
Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)-eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR -2 522 686, OMR -143 214, AED -30 010 627, and AED -5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.
摘要：
背景：全球第二常见的血液肿瘤是多发性骨髓瘤（MM）。在过去的30年里，发病率和死亡率增加了一倍多。临床试验证明了达雷妥单抗方案治疗新诊断的MM（NDMM）的安全性和有效性。目的：评估在三个海湾国家（卡塔尔，阿曼和阿拉伯联合酋长国；阿联酋)，构建了成本最小化模型。方法：我们从社会角度进行了静态成本最小化分析，以评估在5年时间范围内NDMM患者从dara-IV输注转向dara-SC注射相关的成本和资源利用率的可能降低。该模型包括2种情况：当前的情况下，100％的NDMM患者接受dara-IV输注治疗，未来的情况下，dara-SC注射在建模的时间范围内逐渐采用。就每组中的数量和相关的治疗方案而言，该模型在符合自体干细胞移植（ASCT）的NDMM患者和不符合ASCT的NDMM患者之间进行了精确区分。还进行了单向敏感性分析。结果：该模型表明，在符合或不符合ASCT的NDMM患者中使用dara-SC可以降低非药物成本，包括药物前用药费用，不利影响成本，管理费用，医务人员费用，和间接成本。在哈马德医疗公司的模型的5年时间范围内，由此产生的总节省，苏丹卡布斯大学医院/皇家医院，SheikhShakhbout医疗城（SSMC），和Tawam医院分别为QAR-2522686、OMR-143214、AED-30010627和AED-5003471。结论：在卡塔尔引入dara-SC作为NDMM患者的一线治疗（HamadMedicalCorporation），阿曼（苏丹卡布斯大学医院，皇家医院-卫生部），和阿联酋（SSMC和Tawam医院）可以帮助节约资源并最大程度地减少对医疗保健系统的限制。
