Half-Dose Fulvestrant plus Anastrozole as a First-Line Treatment for Hormone Receptor-Positive Metastatic Breast Cancer: A Cost-Effectiveness Analysis

Abstract
Objective The S0226 trial demonstrated that the combination of half-dose fulvestrant (FUL) and anastrozole (ANA) (F&A) caused a significant improvement in overall survival (OS) versus ANA monotherapy for first-line treatment of postmenopausal women with hormone receptor-positive metastatic breast cancer (PMW-MBC[HR+]). The objective of this study was to evaluate the cost-effectiveness of F&A in the first-line treatment for PMW-MBC(HR+) in China.
Design We constructed a Markov model over a life-time horizon. The clinical outcomes and utility data were obtained from published literature. Cost data were obtained from official Chinese websites. Sensitivity analyses were performed to test result uncertainty.
Setting Chinese health care system perspective.
Population A hypothetical cohort of adult patients presenting with PMW-MBC(HR+).
Interventions F&A compared with full-dose FUL and ANA monotherapy.
Main outcome measures The main outcome of this study was the incrementa...

摘要
研究背景 S0226试验证实，相较于阿那曲唑（anastrozole，ANA）单药一线治疗激素受体阳性转移性乳腺癌绝经后女性（PMW-MBC[HR+]），半剂量氟维司群（fulvestrant，FUL）联合阿那曲唑（F&A）方案可显著改善患者总生存期（overall survival，OS）。本研究旨在评估F&A方案用于中国PMW-MBC(HR+)患者一线治疗的成本-效果。
研究设计 本研究构建了终身时限的马尔可夫（Markov）模型。临床结局与效用数据取自已发表文献，成本数据源自中国官方公开渠道。同时开展敏感性分析以检验研究结果的不确定性。
研究视角 采用中国医疗卫生系统视角。
研究人群 假想队列纳入确诊为PMW-MBC(HR+)的成年患者。
干预措施 对比F&A方案与全剂量氟维司群、阿那曲唑单药治疗。
主要结局指标 本研究的主要结局为增量……