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

1.	丁江华, 孔春芳. Akt依赖性与多发性骨髓瘤耐药. 实用医学杂志, 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, 孙万军, 安娜, 等. 来那度胺治疗复发或难治性多发性骨髓瘤患者的临床观察. 中华医学杂志, 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.	张仙土, 付承林, 郑炜智. Survivin在多发性骨髓瘤中的表达及其与VEGF的相关性研究. 中国现代医生, 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, 张琛, 马朱林, 等. 我国多发性骨髓瘤治疗现状及药物经济学研究综. 中国医疗保险, 2015, 2(9): 57-59.
10.	吴鹏强, 景莉, 李晓明. 两种化疗方案治疗初治多发性骨髓瘤的成本-效果分析. 中国药房, 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.	庄韵, 沈群. 多发性骨髓瘤维持治疗的最新进展. 中国实验血液学杂志, 2015, 23(1): 250-254.
13.	菅原. 新药治疗复发难治性多发性骨髓瘤的研究进展. 白血病.淋巴瘤, 2014, 23(6): 375-377.
14.	周枫, 傅全威. 从药占比看医院管理成效. 解放军医院管理杂志, 2013, 20(5): 488, 493.
15.	陈文东, 李剑峰, 杜芬, 等. 硼替佐米在多发性骨髓瘤中的成本效益综述. 中国医疗保险, 2015, 1(6): 55-58.
16.	卢静, 侯健, 张春阳, 等. 硼替佐米再治疗多发性骨髓瘤76例疗效及安全性分析. 中华血液学杂志, 2013, 34(4): 309-312.
17.	梁赜隐, 任汉云, 岑溪南, 等. 硼替佐米为基础的化疗方案治疗多发性骨髓瘤患者的疗效及预后因素分析. 中华血液学杂志, 2014, 35(3): 225-230.

1. 丁江华, 孔春芳. Akt依赖性与多发性骨髓瘤耐药. 实用医学杂志, 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, 孙万军, 安娜, 等. 来那度胺治疗复发或难治性多发性骨髓瘤患者的临床观察. 中华医学杂志, 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. 张仙土, 付承林, 郑炜智. Survivin在多发性骨髓瘤中的表达及其与VEGF的相关性研究. 中国现代医生, 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, 张琛, 马朱林, 等. 我国多发性骨髓瘤治疗现状及药物经济学研究综. 中国医疗保险, 2015, 2(9): 57-59.
10. 吴鹏强, 景莉, 李晓明. 两种化疗方案治疗初治多发性骨髓瘤的成本-效果分析. 中国药房, 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. 庄韵, 沈群. 多发性骨髓瘤维持治疗的最新进展. 中国实验血液学杂志, 2015, 23(1): 250-254.
13. 菅原. 新药治疗复发难治性多发性骨髓瘤的研究进展. 白血病.淋巴瘤, 2014, 23(6): 375-377.
14. 周枫, 傅全威. 从药占比看医院管理成效. 解放军医院管理杂志, 2013, 20(5): 488, 493.
15. 陈文东, 李剑峰, 杜芬, 等. 硼替佐米在多发性骨髓瘤中的成本效益综述. 中国医疗保险, 2015, 1(6): 55-58.
16. 卢静, 侯健, 张春阳, 等. 硼替佐米再治疗多发性骨髓瘤76例疗效及安全性分析. 中华血液学杂志, 2013, 34(4): 309-312.
17. 梁赜隐, 任汉云, 岑溪南, 等. 硼替佐米为基础的化疗方案治疗多发性骨髓瘤患者的疗效及预后因素分析. 中华血液学杂志, 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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