Abstract:
BACKGROUND:Pembrolizumab was recently demonstrated to have survival benefit in patients with recurrent or metastatic head and neck squamous cell carcinoma (r/mHNSCC). However, the cost-effectiveness of pembrolizumab versus chemotherapy in China remains uncertain. OBJECTIVE:This analysis aimed to describe the cost-effectiveness of pembrolizumab versus standard-of-care (SOC) therapy in r/mHNSCC in China. DESIGN:A Markov model consisting of three health states (stable, progressive and dead) was developed to compare the cost and effectiveness of pembrolizumab with SOC in platinum-resistant r/mHNSCC. Model inputs for transition probabilities and toxicity were collected from the KEYNOTE-040 trial, while health utilities were estimated from a literature review. Cost data were acquired for the payer's perspective in China. Costs and outcomes were discounted at an annual rate of 3.0%. Sensitivity analyses were conducted to test the uncertainties surrounding model parameters. OUTCOME MEASURES:The primary outcome was incremental cost-effectiveness ratios (ICERs), which were calculated as the cost per quality-adjusted life years (QALYs). RESULTS:The total mean cost of pembrolizumab and SOC was US$45 861 and US$41 950, respectively. As for effectiveness, pembrolizumab yielded 0.31 QALYs compared with 0.25 QALYs for SOC therapy. The ICER for pembrolizumab versus SOC was US$65 186/QALY, which was higher than the willingness-to-pay threshold (WTP) of US$28 130/QALY in China. The univariate sensitivity analysis indicated that utility values for progressive state, probability from stable to progressive in the SOC group, as well as cost of pembrolizumab were the three most influential variables on ICER. The probabilistic sensitivity analysis demonstrated that standard therapy was more likely to be cost-effective compared with pembrolizumab at a WTP value of US$28 130/QALY. Results were robust across both univariate analysis and probabilistic sensitivity analysis. CONCLUSIONS:Pembrolizumab is not likely to be a cost-effective strategy compared with SOC therapy in patients with platinum-resistant r/mHNSCC in China. TRIAL REGISTRATION NUMBER:NCT02252042; Post-results.
journal_name
BMJ Openjournal_title
BMJ openauthors
Xin W,Ding H,Fang Q,Zheng X,Tong Y,Xu G,Yang Gdoi
10.1136/bmjopen-2020-038867subject
Has Abstractpub_date
2020-12-18 00:00:00pages
e038867issue
12issn
2044-6055pii
bmjopen-2020-038867journal_volume
10pub_type
杂志文章相关文献
BMJ Open文献大全abstract:INTRODUCTION:Chemotherapy may cause infertility in young survivors of breast cancer. Various fertility preservation techniques increase the likelihood of survivors becoming genetic mothers. Disclosure of cancer diagnosis may impact decision making about fertility preservation. This protocol will develop and test the ef...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031739
更新日期:2020-02-10 00:00:00
abstract:OBJECTIVE:Limited research has assessed the association between patterns of body mass index (BMI) change across adulthood and mortality. We aimed to identify groups of individuals who followed specific group-based BMI trajectories across adulthood, using weight collected on three occasions and recalled data from early ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030078
更新日期:2019-08-10 00:00:00
abstract:OBJECTIVES:The study examined medical care utilisation by health insurance status changes. SETTING:The Korean Welfare Panel Study (KoWePs) was used. PARTICIPANTS:This study analysed 14,267 participants at baseline (2006). INTERVENTIONS:The individuals were categorised into four health insurance status groups: contin...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009538
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to investigate the relationship between birth order and stereoacuity among Chinese children aged 60-72 months. DESIGN:Cross-sectional. PARTICIPANTS:1342 children with complete data on the questionnaire, stereoacuity and refraction were included. RESULTS:The mean stereoacuity was 53.2±1.7, ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032833
更新日期:2020-10-12 00:00:00
abstract:OBJECTIVES:To determine how many kidney function tests are done, on whom, how frequently they are performed and how they have changed over time. DESIGN:Retrospective study of all serum creatinine, urine albumin and urine creatinine tests. SETTING:Primary and secondary care in Oxfordshire from 1993 to 2013. PARTICIPA...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009459
更新日期:2015-12-16 00:00:00
abstract:OBJECTIVE:Recent data on sustained hypertension and obesity among school-going children and adolescents in India are limited. This study evaluates the prevalence of sustained hypertension and obesity and their risk factors among urban and rural adolescents in northern India. SETTING:A school-based, cross-sectional sur...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027134
更新日期:2019-09-08 00:00:00
abstract:INTRODUCTION:Depressive, anxiety and adjustment disorders are highly prevalent among mental health outpatients. The lack of funding for mental health problems produces inefficient results and a high burden of disease. New cost-effective group interventions aimed at treating these symptoms might be an appropriate soluti...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029909
更新日期:2019-10-08 00:00:00
abstract:OBJECTIVES:To prevent pain inhibiting their performance, many athletes ingest over-the-counter (OTC) analgesics before competing. We aimed at defining the use of analgesics and the relation between OTC analgesic use/dose and adverse events (AEs) during and after the race, a relation that has not been investigated to da...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002090
更新日期:2013-04-19 00:00:00
abstract:OBJECTIVE:To determine anticoagulant therapy at hospital discharge for patients with acute venous thromboembolism (VTE) and secondarily, to describe factors affecting choice of therapy. DESIGN:A retrospective chart review. SETTING:Canadian hospitals in Edmonton, Alberta (n=4), Regina, Saskatchewan (n=2) and rural Alb...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-022065
更新日期:2018-10-31 00:00:00
abstract:OBJECTIVES:In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technician...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020566
更新日期:2018-05-17 00:00:00
abstract:OBJECTIVES:Evidence about the relationship between socioeconomic status (SES) and small-for-gestational-age (SGA) infants was insufficient among Chinese primiparae. In addition, factors that may mediate this relationship are poorly understood. The purpose of this study was to investigate the risk of and mediators betwe...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-020694
更新日期:2018-06-14 00:00:00
abstract:OBJECTIVE:This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. DESIGN:Population based-survey with a nested case-control study. SETTING:Morropon, a semiurban district located in Piura, northern Peru. PARTICIPANTS:For the population survey, a tw...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011300
更新日期:2016-08-26 00:00:00
abstract:OBJECTIVE:Severe infections are a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Our primary objective was to use data from a large Spanish cohort to develop a risk score for severe infection in SLE, the SLE Severe Infection Score (SLESIS) and to validate SLESIS in a separat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028697
更新日期:2019-06-14 00:00:00
abstract:INTRODUCTION:The creatine kinase circuit is central to the regulation of high-energy phosphate metabolism and the maintenance of cellular energy turnover. This circuit is fuelled by creatine, an amino acid derivative that can be obtained from a diet containing animal products, and by synthesis in the body de novo. A re...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026756
更新日期:2019-01-15 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the caesarean section (CS) rates using Robson's 10-Group Classification System among women who gave birth at Hawassa University Referral Hospital in southern Ethiopia. DESIGN:Cross-sectional study design to determine CS rate using Robson's 10-Group Classification System. ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039098
更新日期:2020-10-28 00:00:00
abstract:OBJECTIVE:This meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH). DESIGN:Sy...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-025656
更新日期:2019-08-30 00:00:00
abstract:INTRODUCTION:A large proportion of malaria-infected individuals in endemic areas do not experience symptoms that prompt treatment-seeking. These asymptomatically infected individuals may retain their infections for many months during which sexual-stage parasites (gametocytes) are produced that may be transmissible to m...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030598
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:Research on patient safety in emergency medical services (EMS) has mainly focused on the organisation's and/or the EMS personnel's perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients' experiences of their sense of safety in EMS. METHODS:A qualitat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037488
更新日期:2020-10-21 00:00:00
abstract:OBJECTIVE:To assess differences in weight status and movement behaviour guideline compliance among children aged 5-12 years with and without a family history of non-communicable diseases (NCDs). DESIGN:Prospective. SETTING AND PARTICIPANTS:Women born between 1973 and 1978 were recruited to the Australian Longitudinal...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038789
更新日期:2020-11-03 00:00:00
abstract:OBJECTIVE:To investigate the association between ambient air pollution and stroke morbidity in different subgroups and seasons. METHODS:We performed a time-series analysis based on generalised linear models to study the short-term exposure-response relationships between air pollution and stroke hospitalisations, and c...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032974
更新日期:2020-03-19 00:00:00
abstract:OBJECTIVE:Persons with type 2 diabetes are often stigmatised for having what is considered a lifestyle-related disease. Accordingly, some blame themselves for their condition, resulting in feelings of low self-worth that ultimately impact their self-management behaviours. However, there are no studies examining why som...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034758
更新日期:2020-08-05 00:00:00
abstract:INTRODUCTION:Asthma-related morbidity and mortality in the UK is higher than elsewhere in Europe. Although the reasons for this are largely unclear, one explanation could be a higher prevalence of poorly controlled asthma in the UK. Findings from our earlier study found that, in a sample of 766 children with asthma, 45...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025867
更新日期:2019-04-23 00:00:00
abstract:OBJECTIVES:To evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery. DESIGN:Prepregnancy cohort study. SETTING:Cohort Norway regional health surveys (1994-2003) linked to Medical Birth Registry of Norway for deliveries thr...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017034
更新日期:2017-08-11 00:00:00
abstract:OBJECTIVE:The objective is to determine if suspected concussions in elite football are medically assessed according to the International Conferences on Concussion in Sport consensus statement recommendations. SETTING:Men's Union of European Football Association (UEFA) Football Championship. PARTICIPANTS:All professio...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024607
更新日期:2019-05-30 00:00:00
abstract:INTRODUCTION:Process evaluations are conducted alongside research projects to identify the context, impact and consequences of research, determine whether it was conducted per protocol and to understand how, why and for whom an intervention is effective. We present a process evaluation protocol for the Getting it Right...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017612
更新日期:2017-11-03 00:00:00
abstract:INTRODUCTION:Bladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC. METHODS AND ANALY...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-041894
更新日期:2021-01-31 00:00:00
abstract:OBJECTIVE:To provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request. SETTING:People who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The Netherlands. P...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029853
更新日期:2019-06-06 00:00:00
abstract:OBJECTIVES:Outcome and comparator choice strongly determine the validity and implementation of clinical trial results. We aimed to assess outcome and comparator choice in intervention studies on molar incisor hypomineralisation (MIH) using systematic review and social network analysis (SNA). DESIGN AND DATA SOURCES:Me...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028352
更新日期:2019-08-02 00:00:00
abstract:OBJECTIVES:Human papillomavirus (HPV) is a well-known cause of cervical cancer, the second most frequent cancer in female African populations. This study aimed at determining the prevalence of HPV infections and the genotype distribution in young adults aged 18-24, in Maputo city, Mozambique, and to assess the suitabil...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015653
更新日期:2017-07-17 00:00:00
abstract:OBJECTIVES:Injury is an important issue in public health. Spinal curvature disorders are deformities characterised by excessive curves of the spine. The prevalence of spinal curvature disorders is not low, but its relationship with injury has not been studied. The aim of this study is to investigate whether spinal curv...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023604
更新日期:2019-01-17 00:00:00