Use of data-mining to support real-world cost analyses: An example using HER2-positive breast cancer in Iran.
Use of data-mining to support real-world cost analyses: An example using HER2-positive breast cancer in Iran.
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DOI：
10.1371/journal.pone.0205079
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Redekop WK
中科院分区：
文献类型：
--
作者：
Ansaripour A;Zendehdel K;Tadayon N;Sadeghi F;Uyl-de Groot CA;Redekop WK
患者登记在获得治疗成本效益的真实证据方面发挥着重要作用。然而，在许多中等收入国家，它们的实施成本高昂，有时也不可行。我们探索了数据挖掘和大型索赔数据库的结合，以估计伊朗her2阳性乳腺癌（BC）治疗的直接医疗成本和曲妥珠单抗使用占总成本的比例。我们对2011年3月21日至2014年3月20日期间来自伊朗社会保障组织的索赔数据进行了回顾性分析，该组织是一家健康保险公司，覆盖了大约50%（约4000万）的伊朗人口。使用R软件并使用癌症研究中心的患者档案进行验证的数据挖掘算法确定了1295名患者，并将其分为三个主要的her2阳性乳腺癌阶段（早期，局部区域和晚期）。从付款人的角度来计算与治疗her2阳性乳腺癌相关的医疗服务在公共和私人医疗系统的绝对和相对直接成本。女性人数为802人（早期），125人（地方）和218人（高级）。平均年龄[SD]分别为45岁、46岁和48岁，各阶段平均随访时间约为1年。早期、局部区域和晚期直接医疗保健的平均费用分别为11,796欧元（95%置信区间：9,356欧元至12,498欧元）、8,253欧元（95%置信区间：6,843欧元至10,002欧元）和17,742欧元（95%置信区间：15,720欧元至19,505欧元）。曲妥珠单抗在所有三个阶段的总成本中占最大份额（范围：53-76%）。在全面的患者登记不可行或成本高昂的地方，可以通过索赔数据库和数据挖掘策略来估计实际成本。使用这种方法，已经估算了伊朗的实际成本。该研究得出的阶段特异性成本估算可用于her2阳性BC治疗的实际成本效益分析，并支持医疗融资决策。
Patient registries play an important role in obtaining real-world evidence of the cost-effectiveness of treatments. However, their implementation is costly and sometimes infeasible in many middle-income countries (MICs). We explored the combination of data-mining and a large claims database to estimate the direct healthcare costs of HER2-positive breast cancer (BC) treatment in Iran and the fraction of total costs from trastuzumab use. We performed a retrospective analysis of claims data from the Iran Social Security Organization, a health insurer which covers approximately 50%(~40 million) of the Iranian population, in the period of 21/03/2011-20/03/2014. A data-mining algorithm using R software and validated using patient dossiers in the Cancer Research Center identified 1295 patients and divided them into the three main HER2-positive breast cancer stages (early, loco-regional and advanced). A payer perspective was used to calculate the absolute and relative direct costs of healthcare services associated with the treatment of HER2-positive breast cancer in the public and private healthcare systems. The number of women totaled 802 (early), 125 (loco-regional) and 218 (advanced). The mean age[SD] was 45, 46 and 48 years, respectively, while mean follow-up in all stages was approximately one year. Average costs of direct healthcare care in early, loco-regional and advanced stages were €11,796 (95%CI: €9,356-€12,498), €8,253 (95%CI: €6,843-€10,002), and €17,742 (95%CI: €15,720-€19,505), respectively. Trastuzumab accounted for the largest share of total costs in all three stages (range: 53–76%). Wherever comprehensive patient registries are infeasible or costly, real-world costs can be estimated through claims databases and data-mining strategies. Using this method, real-world costs have been estimated in Iran. The stage-specific cost estimates derived from this study can be used to perform real-world cost-effectiveness analyses of therapies for HER2-positive BC and support healthcare financing decisions.
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影响因子：
3.8
作者：
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瑞典国家住院患者登记册的外部审查和验证。
影响因子：
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通讯作者：
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