Real-world results of immune checkpoint inhibitors from the Taiwan National Health Insurance Registration System
Real-world results of immune checkpoint inhibitors from the Taiwan National Health Insurance Registration System
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DOI：
10.26355/eurrev_202111_27097
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发表时间：
2021-01-01
影响因子：
3.3
通讯作者：
Lee, P-C
中科院分区：
文献类型：
--
作者：
Hsieh, S-T;Ho, H-F;Lee, P-C
目的：免疫检查点抑制剂（ICI）是癌症治疗的一项重大进展。但其支付利益不明确，造成财务风险。在台湾，国家健康保险管理局（NHIA）通过收集和评估真实世界的证据（如病例登记数据）来调整风险分担机制，以涵盖ICI，从而调整每种药物的福利包。患者和方法：这项全国性的、多中心的、回顾性队列研究评估了由NHIA报销的用于治疗台湾多种晚期癌症的ICI的真实使用、有效性和安全性。我们主要从NHIA免疫检查点抑制剂注册数据库获得数据。结果：2019年4月1日。2020年3月31日，1644名患者接受了至少一剂ICI。总有效率（RR）为29.1%。不适合化疗的转移性尿路上皮癌的RR最高。估计的中位无进展生存期（PFS）为2.8个月（95%置信区间[CI]=2.7-3个月）。肾细胞癌的PFS最长。除了样本量较小的经典型霍奇金淋巴瘤外，大多数癌症患者均达到了中位PFS。结论：在国家药品注册追踪制度下，台湾的高成本药品政策使患者能够获得新药，并使患者利益最大化。
OBJECTIVE: Immune checkpoint inhibitors (ICIs) are a major advance in cancer treatment. but their payment benefits are unclear, resulting in financial risk. In Taiwan, the National Health Insurance Administration (NHIA) has adapted risk-sharing mechanisms to cover ICIs by collecting and assessing real-world evidence, such as case registration data, to adjust benefit packages for each medication. increase payment benefits of ICIs, and enable national health insurance sustainability.PATIENTS AND METHODS: This nationwide, multicenter, retrospective cohort study assessed the real-world use, effectiveness, and safety of ICIs reimbursed by the NHIA for treating multiple advanced cancers in Taiwan. We obtained data mainly from the NHIA Immune Checkpoint Inhibitor Registry Database.RESULTS: Between April 1, 2019. and March 31, 2020, 1644 patients received at least one dose of ICIs. The overall response rate (RR) was 29.1%. The metastatic urothelial carcinoma of patients ineligible for chemotherapy showed the highest RR. The estimated median progression-free survival (PFS) was 2.8 months (95% confidence interval [CI]=2.7-3 months). and renal cell carcinoma showed the longest PFS. The median PFS was reached in patients with most cancers except classic Hodgkin's lymphoma, which had a small sample size. The estimated survival probability was 50%.CONCLUSIONS: Under the national registration tracking system, Taiwan's high-cost drug policy has enabled access to new medicines and maximized patient benefits.