不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Follicular lymphoma or diffuse large B-cell lymphoma: a population based analysis of epidemiological and health economic aspects in Germany.
Follicular lymphoma or diffuse large B-cell lymphoma: a population based analysis of epidemiological and health economic aspects in Germany.
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基于常规诊疗中流行病学、医疗资源利用(HCRU)、费用和临床结局的最新信息,对于价值导向决策至关重要。然而,德国滤泡性淋巴瘤(FL)和弥漫大B细胞淋巴瘤(DLBCL)相关信息仍然有限。
本研究旨在填补这些证据空白。这项回顾性横断面疾病经济负担研究分析了匿名法定医疗保险理赔数据(2015–2020)。通过住院或门诊ICD编码识别FL I–IIIa级(ICD-10:C82.0–C82.3)和DLBCL(ICD-10:C83.3)患者。采用Elixhauser和Charlson合并症指数描述总体合并症负担。FL患病率由每10万名参保人26例升至32例(n=837升至1,028);DLBCL患病率由每10万名37例升至45例(n=1,205升至1,437)。2015–2020年间,平均年龄(FL:67.0±13岁;DLBCL:68.6±13.6岁)和性别分布(FL女性50%;DLBCL女性44%)保持稳定。
Charlson合并症指数均值分别为FL 4.1±2.4、DLBCL 4.8±2.7;Elixhauser指数均值分别为FL 5.2±3.0、DLBCL 6.1±3.3。住院率为:FL患者64%住院(每年平均住院2.0±2.3次、住院21±44.7天);DLBCL患者78%住院(每年平均住院2.9±3.1次、住院29±47.5天)。从第三方支付方角度计算的患者年均费用为FL 15,258欧元、DLBCL 23,455欧元。移植后12个月费用为:自体造血干细胞移植后FL 46,270欧元、DLBCL 56,558欧元;异基因移植后DLBCL为161,662欧元。患病率上升要求持续评估真实世界HCRU和费用。
本研究补充了有限的现有证据,并凸显其显著经济影响。尽管医保数据能提供有价值的见解,但缺乏临床细节,因而需要与其他数据源整合。目前多个计划正在建设数据空间以增强证据生成;与此同时,基于单一数据源的分析仍可为临床实践和政策制定提供有价值的参考。
Contemporary information on epidemiology, healthcare resource utilization (HCRU), costs and clinical outcomes in routine care is essential for value-based decision-making.
However, such information remains limited for follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) in Germany.
This study addresses these gaps. This retrospective cross-sectional cost-of-illness study analyzed anonymized statutory health insurance claims data (2015-2020). FL Grade I-IIIa (ICD-10: C82. 0-C82. 3), DLBCL (ICD-10: C83. 3) patients were identified via inpatient or outpatient ICD coding. Elixhauser and Charlson Comorbidity Indices were used to describe the general comorbidity burden. FL prevalence increased from 26 to 32 per 100,000 insured persons (n = 837 to 1,028), DLBCL prevalence rose from 37 to 45 per 100,000 (n = 1,205 to 1,437). Mean age (FL: 67. 0 13; DLBCL: 68. 6 13.
6) and sex distribution (FL: 50% female; DLBCL: 44% female) remained stable 2015-2020. Mean Charlson Comorbidity Index 4. 1 2. 4 (FL), 4. 8 2. 7 (DLBCL), mean Elixhauser 5. 2 3. 0 (FL), 6. 1 3. 3 (DLBCL). Hospitalization rates: 64% of FL patients (2. 0 2. 3 admissions, 21 44. 7 days/year); 78% of DLBCL patients (2. 9 3.
1 admissions, 29 47. 5 days/year). Mean annual costs per patient in third-party payers perspective were 15,258 (FL), 23,455 (DLBCL). Post-SCT 12-month costs were 46,270 (FL), 56,558 (DLBCL) for autologous-SCT, and 161,662 for allogeneic-SCT (DLBCL only). Rising prevalence calls for ongoing real-world assessment of HCRU and costs.
This study supplements limited evidence, highlighting significant economic impact. While health insurance data offer valuable insights, their lack of clinical details necessitates integration with other data sources. Several initiatives are building data spaces to enhance evidence generation; meanwhile, analyses based on single data sources remain valuable to inform practice and policy.
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