瑞戈非尼三线治疗转移性结直肠癌的预算影响分析

Budget Impact Analysis on the Treatment of Metastatic Colorectal Cancer by the Third Line of Regorafenib

目的:在转移性结直肠癌(mCRC)三线治疗的患者中,通过评估瑞戈非尼纳入中国医保报销系统对医保基金产生的影响,为药品报销目录的遴选决策提供科学依据。方法:构建预算影响分析模型,评估将瑞戈非尼纳入中国医保报销系统后未来3年对医保基金支出的影响。模型中,适应症人群发病率的数据来源文献分析,疾病的诊断率、治疗率和直接医疗成本等数据来源于专家意见,各三线治疗方案的市场份额等其他数据来源于市场调研。结果:瑞戈非尼纳入医保之前与纳入之后基础分析的结果显示,未来3年内可节省医保基金支出分别为9,024万元、6,699元、4,676万元。对瑞戈非尼的月治疗费用、市场份额以及医保报销比例分别进行敏感性分析,研究结论未发生改变,说明基础分析结果具有稳健性。结论:该分析预计,将瑞戈非尼纳入中国医保报销系统用于转移性结直肠癌(mCRC)患者的三线治疗,在增加医疗受益的同时节约了整体医保支出。

Objectives:To evaluate the impact of Regorafenib in the third-line treatment of patients with metastatic colorectal cancer(mCRC)on the insurance budget.This would provide evidence for medical insurance decision makers.Methods:Building a budget impact model to acces the impact of Stivarga on healthcare fund expenditure over the followingt three years after the inclusion of Regorafenib in China's national reimbursement drug list(NRDL).In the model,the incidence data come from literature,disease diagnosis rate,treatment rate and direct medical costs are based on expert opinion.Other data such as market share of third-line treatment are derived from market research.Results:Total annual reimbursement costs in the following 3 years were decreased by 90 million RMB,67 million RMB and 47 million RMB,comparing before Regorafenib entry with post-entry.Sensitivity analysis was carried out on the monthly cost of treatment,market share and reimbursement ratio.The results of the study do not change,indicating that the basic analysis results are robust.Conclusions:The analysis predict that the inclusion of Regorafenib in China's NRDL for third-line treatment of patients with metastatic colorectal cancer(mCRC)will result in increased health benefi ts while saving overall health care expenditures.