度伐利尤单抗用于Ⅲ期非小细胞肺癌放化疗后巩固治疗的成本-效用分析 点击下载
| 论文标题： | 度伐利尤单抗用于Ⅲ期非小细胞肺癌放化疗后巩固治疗的成本-效用分析 |
| 英文标题： | |
| 中文摘要： | 目的 从我国卫生体系角度出发，评价度伐利尤单抗用于不可手术切除、Ⅲ期非小细胞肺癌放化疗后巩固治疗的经济性。方法利用PACIFIC试验2021年5月更新的4年生存数据和相关文献数据建立马尔可夫模型，模拟时限为20年，循环周期为2周，以质量调整生命年（QALY）为健康产出指标，评价度伐利尤单抗用于不可手术切除、Ⅲ期非小细胞肺癌放化疗后巩固治疗的经济性。对成本和健康产出采用5％的贴现率进行贴现；采用单因素敏感性分析和概率敏感性分析验证基础分析结果的稳健性。结果基础分析结果显示，与安慰剂组相比，度伐利尤单抗组患者可多获得0.73QALYs，多花费1076062.86元成本，增量成本-效果比（ICER）为1467546.54元/QALY，远高于3倍2020年我国人均国内生产总值（GDP，即217713元）作为的意愿支付（WTP）阈值。单因素敏感性分析结果显示，度伐利尤单抗价格和贴现率对ICER值的影响较大。概率敏感性分析结果显示，当WTP阈值为3倍2020年我国人均GDP（217713元）时，度伐利尤单抗具有经济性的概率为0。结论从我国卫生体系角度出发，当WTP阈值为3倍2020年我国人均GDP时，度伐利尤单抗用于不可手术切除、Ⅲ期非小细胞肺癌放化疗后巩固治疗不具有经济性。 |
| 英文摘要： | OB JECTIVE To evaluate the cost-effectiveness of durvalumab for consolidation therapy after chemoradiotherapy for unresectable stage Ⅲ non-small cell lung cancer from the perspective of the Chinese health care system. METHODS A Markov model was developed by using updated four-year survival data from the PACIFIC trial in May 2021 and relevant literature. The cost-effectiveness of durvalumab for consolidation therapy after chemoradiotherapy for unresectable stage Ⅲ non-small cell lung cancer was evaluated by using quality-adjusted life years （QALYs）as health output index with 20-year simulation time frame and a 2-week cycling period. The costs and health output were discounted using discount rate of 5％；one-way sensitivity analysis and probabilistic sensitivity analysis were used to examine the robustness of the model simulation results. RESULTS The results of the base analysis showed that compared with placebo group ，durvalumab resulted in 0.73 QALYs at an incremental cost of 1 076 062.86 yuan and an incremental cost-utility ratio （ICER）of 1 467 546.54 yuan/QALY，which was much higher than 3-fold per capita gross domestic products （GDP）in 2020（217 713 yuan）as willingness-to-pay （WTP）threshold. The results of one-way sensitivity analysis showed that the price of durvalumab and discount rate had a great impact on ICER. Probabilistic sensitivity analysis showed no cost-effective advantage for durvalumab when the WTP threshold was three times of GDP per capita in 2020 （217 713 yuan）. CONCLUSIONS From the perspective of Chinese health care system ，there is no cost-effective advantage to the use of durvalumab for consolidation therapy after chemoradiotherapy for unresectable stage Ⅲ non-small cell lung cancer when the WTP threshold was three times of GDP per capita in 2020. |
| 期刊： | 2022年第33卷第15期 |
| 作者： | 史健，齐冉，高胜男，刘旭婷，杜桂平，刘国强 |
| 英文作者： | SHI Jian，QI Ran，GAO Shengnan ，LIU Xuting ，DU Guiping ，LIU Guoqiang |
| 关键字： | 度伐利尤单抗；非小细胞肺癌；巩固治疗；药物经济学；成本-效用分析 |
| KEYWORDS： | durvalumab；non-small cell lung cancer ；consolidation therapy ；pharmacoeconomics；cost-utility analysis |
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| 文件大小： | 619.60Kb |
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