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![点击此处可从《The Canadian journal of economics》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Evaluate the cost-effectiveness of primary vs secondary prophylaxis (PP vs SP) with pegfilgrastim to reduce the risk of febrile neutropenia (FN) in Non-Hodgkin’s Lymphoma (NHL) patients receiving myelosuppressive chemotherapy from a US payer perspective.
Methods:
A Markov model was used to compare PP vs SP with pegfilgrastim in a cohort of patients receiving six cycles of cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) or CHOP plus rituximab (CHOP-R) chemotherapy. Model inputs, including efficacy of pegfilgrastim in reducing risk of FN and costs, were estimated from publicly available sources and peer-reviewed publications. Incremental cost-effectiveness was evaluated in terms of net cost per life-year saved (LYS), per quality-adjusted life-year (QALY) gained, and per FN event avoided over a lifetime horizon. Deterministic and probabilistic analyses were performed to assess sensitivity and robustness of results.
Results:
Lifetime costs for PP were $5000 greater than for SP; however, PP was associated with fewer FN events and more LYs and QALYs gained vs SP. Incremental cost-effectiveness ratios (ICERs) for PP vs SP for CHOP were $13,400 per FN event avoided, $29,500 per QALY gained, and $25,800 per LYS. CHOP-R results were similar ($15,000 per FN event avoided, $33,000 per QALY gained, and $28,900 per LYS). Results were most sensitive to baseline FN risk, cost per FN episode, and odds ratio for reduced relative dose intensity due to prior FN event. PP was cost-effective vs SP in 85% of simulations at a $50,000 per QALY threshold.
Limitations:
In the absence of NHL-specific data, estimates for pegfilgrastim efficacy and relative risk reduction of FN were based on available data for neoadjuvant TAC in patients with breast cancer. Baseline risks of FN for CHOP and CHOP-R were assumed to be equivalent.
Conclusions:
PP with pegfilgrastim is cost-effective compared to SP with pegfilgrastim in NHL patients receiving CHOP or CHOP-R. 相似文献
Up until now, studies on entrepreneurs and their relationship to business performance have focused primarily on analyzing the entrepreneur as an individual. While studies have been conducted on the entrepreneurial team, their focus has centered on team size and degree of diversity - cultural, age, gender - leaving a gap in the analysis of the effect of a team’s competencies on the outcome of the ventures. This research aims to help fill this gap by using the psychometric instrument DISC. This research analyzes entrepreneurship by opportunity, evaluating the performance of 109 Colombian companies and the composition of their entrepreneurial teams. The results obtained provide the basis for better understanding of the make-up of entrepreneurial teams, considering the variances and interdependencies of the competency development level among their members. They reveal that identifying the similarity or heterogeneity in certain groups of competencies, as well as how developed they are, can have an impact on the ventures’ success. The cluster analysis carried out suggests that highly developed competencies associated with the ‘dominance’ dimension in the members of an entrepreneurial team are essential. These must be above-average in heterogeneous levels among the team members. They must also be accompanied by the ‘steadiness’ competency provided by the team-oriented partners, as well as an average, homogeneous level of competencies associated with ‘conscientiousness’ if the new business is to achieve good financial results in its early years. The ‘influence’ dimension did not play a significant role. The teams made up of more homogeneous partners obtained the poorest financial results. Furthermore, the study provides new perspectives for measuring business performance in a venture, as well as for evaluating the relationships between the entrepreneurial team's competencies and the company’s results in the first years of business. Accordingly, it offers inputs for future research.
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