Analysis of curative effect, hospitalization cost and cost-effect of different treatments for patients with multiple myeloma_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Shuaifei ¹ , ZHOU Fan ² ,  PAN Xiudan ¹ , GUAN Nannan ¹ , WEN Xin ¹ , QI Yingying ³

1. Department of Health Statistics, School of Public Health, Shenyang Medical College, Shenyang 110034, P.R.China;
2. Department of Hematology, General Hospital of Shenyang Military Command, PLA, Shenyang 110016, P.R.China;
3. Department of Occupational and Environmental Health, School of Public Health, Shenyang Medical College, Shenyang 110034, P.R.China;

Corresponding?author：

PAN Xiudan, Email: xiudanp@aliyun.com

Keywords：

Multiple myeloma; Efficacy; Cost; Cost-effect analysis; Targeted drug

DOI：

10.7507/1672-2531.201908112

Video：

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Objective To analyze the efficacy, hospitalization cost and cost-effect of different treatments for multiple myeloma, so as to provide references for the treatment and development medical insurance payment policy of multiple myeloma.Methods A total of 60 cases of multiple myeloma patients who were treated in the General Hospital of Shenyang Military Command from January 1^st, 2013 to December 31^st, 2017 were included. According to the treatment method, they were categorized into the traditional treatment group (n=37) and novel drug treatment group (n=23). The total response rate and hospitalisation expenses for patients with medical insurance of the two groups were calculated and compared, and cost-effectiveness analysis was then performed.Results The overall response rate in patients in traditional treatment group was 56.76% (21/37), and in novel drug treatment group was 82.61% (19/23) (χ²=4.366, P=0.039). The annual average drug fee, annual average novel drug fee, secondary average drug fee, secondary average novel drug fee, annual average total cost, and secondary average total cost of the medical insurance patients in the novel drug treatment group were significantly higher than those in the traditional treatment group (P<0.05). The annual average cost of personal and coordinated payment for the medical insurance patients in the novel drug treatment group were 172 229.53 yuan and 48 237.51 yuan, respectively, which were significantly higher than the traditional treatment group (P<0.01). The cost-effectiveness ratio of the traditional treatment group was 884.44 yuan/%, the novel drug treatment group was 2 821.80 yuan/%, the cost-effective incremental ratio was 7 075.75 yuan/%, the incremental cost-effective ratio was 7 075.75 yuan/%, and the sensitivity analysis was consistent with the results.Conclusions The total response rate of novel drug treatment is significantly higher than traditional treatment. However, novel drug treatment costs higher, and patient's economic burden is also higher. The traditional treatment is superior to novel drug treatment in cost-effectiveness analysis.

Citation： WANG Shuaifei, ZHOU Fan, PAN Xiudan, GUAN Nannan, WEN Xin, QI Yingying. Analysis of curative effect, hospitalization cost and cost-effect of different treatments for patients with multiple myeloma. Chinese Journal of Evidence-Based Medicine, 2020, 20(7): 764-768. doi: 10.7507/1672-2531.201908112 Copy

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2.	Hashimoto S, Kuroha T, Yano T, et al. The addition of low-dose thalidomide to bortezomib and dexamethasone for refractory multiple myeloma. Inter Med, 2016, 55(20): 3025-3028.
3.	Qiao SK, Guo XN, Ren JH, et al. Efficacy and safety of lenalidomide in the treatment of multiple myeloma: a systematic review and meta-analysis of randomized controlled trials. Chin Med J (Engl), 2015, 128(9): 1215-1222.
4.	Wang L, Xu YL, Zhang XQ. Bortezomib in combination with thalidomide or lenalidomide or doxorubicin regimens for the treatment of multiple myeloma: a meta-analysis of 14 randomized controlled trials. Leuk Lymphoma, 2014, 55(7): 1479-1488.
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6.	Shannon E, Sandoval F, Greig N, et al. Lenalidomide alone or lenalidomide plus dexamethasone significantly inhibit IgG and IgM in vitro: A possible explanation for their mechanism of action in treating multiple myeloma. Int Immunopharmacol, 2012, 12(2): 441-446.
7.	張仙土, 付承林, 鄭煒智. Survivin在多發性骨髓瘤中的表達及其與VEGF的相關性研究. 中國現代醫生, 2013, 51(9): 95-96, 99.
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10.	吳鵬強, 景莉, 李曉明. 兩種化療方案治療初治多發性骨髓瘤的成本-效果分析. 中國藥房, 2015, 26(23): 3169-3172.
11.	San Miguel JF, Schlag R, Khuageva NK, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med, 2008, 359(9): 906-917.
12.	莊韻, 沈群. 多發性骨髓瘤維持治療的最新進展. 中國實驗血液學雜志, 2015, 23(1): 250-254.
13.	菅原. 新藥治療復發難治性多發性骨髓瘤的研究進展. 白血病.淋巴瘤, 2014, 23(6): 375-377.
14.	周楓, 傅全威. 從藥占比看醫院管理成效. 解放軍醫院管理雜志, 2013, 20(5): 488, 493.
15.	陳文東, 李劍峰, 杜芬, 等. 硼替佐米在多發性骨髓瘤中的成本效益綜述. 中國醫療保險, 2015, 1(6): 55-58.
16.	盧靜, 侯健, 張春陽, 等. 硼替佐米再治療多發性骨髓瘤76例療效及安全性分析. 中華血液學雜志, 2013, 34(4): 309-312.
17.	梁賾隱, 任漢云, 岑溪南, 等. 硼替佐米為基礎的化療方案治療多發性骨髓瘤患者的療效及預后因素分析. 中華血液學雜志, 2014, 35(3): 225-230.

1. 丁江華, 孔春芳. Akt依賴性與多發性骨髓瘤耐藥. 實用醫學雜志, 2013, 29(4): 667-669.
2. Hashimoto S, Kuroha T, Yano T, et al. The addition of low-dose thalidomide to bortezomib and dexamethasone for refractory multiple myeloma. Inter Med, 2016, 55(20): 3025-3028.
3. Qiao SK, Guo XN, Ren JH, et al. Efficacy and safety of lenalidomide in the treatment of multiple myeloma: a systematic review and meta-analysis of randomized controlled trials. Chin Med J (Engl), 2015, 128(9): 1215-1222.
4. Wang L, Xu YL, Zhang XQ. Bortezomib in combination with thalidomide or lenalidomide or doxorubicin regimens for the treatment of multiple myeloma: a meta-analysis of 14 randomized controlled trials. Leuk Lymphoma, 2014, 55(7): 1479-1488.
5. 李新, 孫萬軍, 安娜, 等. 來那度胺治療復發或難治性多發性骨髓瘤患者的臨床觀察. 中華醫學雜志, 2015, 95(10): 745-748.
6. Shannon E, Sandoval F, Greig N, et al. Lenalidomide alone or lenalidomide plus dexamethasone significantly inhibit IgG and IgM in vitro: A possible explanation for their mechanism of action in treating multiple myeloma. Int Immunopharmacol, 2012, 12(2): 441-446.
7. 張仙土, 付承林, 鄭煒智. Survivin在多發性骨髓瘤中的表達及其與VEGF的相關性研究. 中國現代醫生, 2013, 51(9): 95-96, 99.
8. Durie BG, Harousseau JL, Miguel JS, et al. International uniform response criteria for multiple myeloma. Leukemia, 2006, 20(9): 1467-1473.
9. 朱水清, 張琛, 馬朱林, 等. 我國多發性骨髓瘤治療現狀及藥物經濟學研究綜. 中國醫療保險, 2015, 2(9): 57-59.
10. 吳鵬強, 景莉, 李曉明. 兩種化療方案治療初治多發性骨髓瘤的成本-效果分析. 中國藥房, 2015, 26(23): 3169-3172.
11. San Miguel JF, Schlag R, Khuageva NK, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med, 2008, 359(9): 906-917.
12. 莊韻, 沈群. 多發性骨髓瘤維持治療的最新進展. 中國實驗血液學雜志, 2015, 23(1): 250-254.
13. 菅原. 新藥治療復發難治性多發性骨髓瘤的研究進展. 白血病.淋巴瘤, 2014, 23(6): 375-377.
14. 周楓, 傅全威. 從藥占比看醫院管理成效. 解放軍醫院管理雜志, 2013, 20(5): 488, 493.
15. 陳文東, 李劍峰, 杜芬, 等. 硼替佐米在多發性骨髓瘤中的成本效益綜述. 中國醫療保險, 2015, 1(6): 55-58.
16. 盧靜, 侯健, 張春陽, 等. 硼替佐米再治療多發性骨髓瘤76例療效及安全性分析. 中華血液學雜志, 2013, 34(4): 309-312.
17. 梁賾隱, 任漢云, 岑溪南, 等. 硼替佐米為基礎的化療方案治療多發性骨髓瘤患者的療效及預后因素分析. 中華血液學雜志, 2014, 35(3): 225-230.

Chinese Journal of Evidence-Based Medicine

Analysis of curative effect, hospitalization cost and cost-effect of different treatments for patients with multiple myeloma

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