■泌乳素瘤,最常见的垂体腺瘤,通常用多巴胺激动剂(DA)治疗,如卡麦角林。手术是二线治疗,如果手术治疗失败或复发性大泌乳素瘤,则使用放射疗法。
■本研究旨在为意大利泌乳素瘤的治疗提供经济证据,使用考虑各种治疗方案的疾病成本和成本效用分析,包括卡麦角林,溴隐亭,替莫唑胺,放射治疗,和手术策略。
■研究人员在科学数据库中对每个研究问题进行了系统的文献综述,并调查了一个专家小组,以了解每个治疗程序的特定驱动因素,这些因素对其总成本有贡献。
■对于患有微泌乳素瘤和大型泌乳素瘤的受试者,第一年的平均治疗费用为2,558.91欧元和3,287.40欧元,分别。两组初始治疗后第二年至第五年的后续费用分别为每年798.13欧元和1,084.59欧元。卡麦角林具有足够的成本效用概况,与溴隐亭相比,增量成本效益比(ICER)为3,201.15欧元,基于参考经济中每个质量调整生命年(QALY)4万欧元的支付意愿。内镜手术比卡麦角林更具成本效益,ICER为44,846.64欧元。考虑到愿意支付40,000欧元/QALY,基线研究结果表明,卡麦角林具有高成本效用和内窥镜手术略高于这一点。
■由于手术治疗的有利成本效用和安全性,垂体手术应更频繁地被考虑作为最初的治疗方法。这种管理选择可以带来更好的结果和医疗资源的适当分配。
UNASSIGNED: Prolactinoma, the most common pituitary adenoma, is usually treated with dopamine agonist (DA) therapy like cabergoline. Surgery is second-line therapy, and radiotherapy is used if surgical treatment fails or in relapsing macroprolactinoma.
UNASSIGNED: This study aimed to provide economic evidence for the management of prolactinoma in Italy, using a cost-of-illness and cost-utility analysis that considered various treatment options, including cabergoline,
bromocriptine, temozolomide, radiation therapy, and surgical strategies.
UNASSIGNED: The researchers conducted a systematic literature review for each research question on scientific databases and surveyed a panel of experts for each therapeutic procedure\'s specific drivers that contributed to its total cost.
UNASSIGNED: The average cost of the first year of treatment was €2,558.91 and €3,287.40 for subjects with microprolactinoma and macroprolactinoma, respectively. Follow-up costs from the second to the fifth year after initial treatment were €798.13 and €1,084.59 per year in both groups. Cabergoline had an adequate cost-utility profile, with an incremental cost-effectiveness ratio (ICER) of €3,201.15 compared to
bromocriptine, based on a willingness-to-pay of €40,000 per quality-adjusted life year (QALY) in the reference economy. Endoscopic surgery was more cost-effective than cabergoline, with an ICER of €44,846.64. Considering a willingness-to-pay of €40,000/QALY, the baseline findings show cabergoline to have high cost utility and endoscopic surgery just a tad above that.
UNASSIGNED: Due to the favorable cost-utility profile and safety of surgical treatment, pituitary surgery should be considered more frequently as the initial therapeutic approach. This management choice could lead to better outcomes and an appropriate allocation of healthcare resources.