2023年，最终的PAOLA-1试验（NCT02477644）生存数据已发表，记录了奥拉帕尼加贝伐单抗治疗晚期卵巢癌（AOC）患者的益处，其受分子状况影响。鉴于这些新数据，本研究旨在评估奥拉帕尼加贝伐单抗治疗总体AOC患者人群以及同源重组缺陷（HRD）阳性患者、携带乳腺癌易感基因（BRCA）突变、同源重组能力（HRD）阳性患者或不携带BRCA突变的患者，以美国保险人的视角来看的经济效益。采用15年的时间范围，使用Markov状态转移模型评估了接受奥拉帕尼加贝伐单抗与单一使用贝伐单抗的患者的结果。在本研究中，考虑到150,000美元/ QALY的支付意愿（WTP）阈值，对人口的生命年（LYs），质量调整LYs（QALYs）和增量成本效益比率（ICER）进行了评估。通过敏感性分析评估了确定模型的稳定性。相对于单一使用贝伐单抗，奥拉帕尼加贝伐单抗与增量成本和QALYs（LYs）相关，奥拉帕尼加贝伐单抗与贝伐单抗的平均增量成本和QALYs（LYs）为：总体AOC患者为293,656美元和1.85（2.16），BRCA突变阳性患者为265,668美元和3.34（4.02），HRD阳性患者为242,746美元和1.71（2.06），HRD阳性BRCA突变阴性患者为193,792美元和0.97（1.14）。这些患者亚组的对应ICER值分别为：158,729美元（136,218美元），79,434美元（66,120美元），141,636美元（117,747美元）和200,595美元（169,733美元）每QALY（LY）增益 敏感性分析确定了效用价值和奥拉帕尼的价格是影响这些结果的主要因素。在当前价格水平下，奥拉帕尼加贝伐单抗的维持治疗可能是美国BRCA突变和HRD阳性AOC患者的经济有效治疗选择。©2023. BioMed Central Ltd., a Springer Nature公司。

In 2023, the final PAOLA-1 trial (NCT02477644) survival data were published documenting the benefits of therapy consisting of olaparib plus bevacizumab for patients with advanced ovarian cancer (AOC) as a function of molecular status. In light of these new data, the present study was conducted with the goal of evaluating the cost-effectiveness of olaparib plus bevacizumab for the treatment of the overall AOC patient population and for homologous recombination deficiency (HRD)-positive patients, patients with a breast cancer susceptibility gene (BRCA) mutations, homologous recombination proficiency (HRD)-positive, or patients not harboring BRCA mutations AOC from a US payers perspective.A Markov state-transition model with a 15-year time horizon was used to evaluate outcomes of patients administered Olaparib plus bevacizumab versus bevacizumab. Life-years (LYs), quality-adjusted LYs (QALYs), and the incremental cost-effectiveness ratio (ICER) values were evaluated in this study in light of a $150,000/QALY of willingness-to-pay (WTP) threshold. The stability of the established model was evaluated through sensitivity analyses.Relative to bevacizumab alone, Olaparib plus bevacizumab was associated with mean incremental costs and QALYs (LYs) of olaparib plus bevacizumab versus bevacizumab were $293,656 and 1.85 (2.16), $265,668 and 3.34 (4.02), $242,746 and 1.71 (2.06), and $193,792 and 0.97 (1.14) for overall, BRCA mutation-positive, HRD-positive, and HRD-positive BRCA mutation-negative AOC patients, respectively. The corresponding ICER values for these patient subgroups were $158,729 ($136,218), $79,434 ($66,120), $141,636 ($117,747), and $200,595 ($169,733) per QALY (LY) gained Utility value and the price of olaparib were identified in sensitivity analyses as the primary factors influencing these results.At current pricing levels, maintenance treatment with olaparib plus bevacizumab treatment may represent a cost-effective therapeutic option for BRCA mutations and HRD-positive AOC patients in the USA.© 2023. BioMed Central Ltd., part of Springer Nature.