维迪西妥单抗联合特瑞普利单抗一线治疗HER2表达局部晚期或转移性尿路上皮癌的成本-效用分析 点击下载
| 论文标题： | 维迪西妥单抗联合特瑞普利单抗一线治疗HER2表达局部晚期或转移性尿路上皮癌的成本-效用分析 |
| 英文标题： | |
| 中文摘要： | 目的 从中国卫生体系视角，评价维迪西妥单抗（DV）联合特瑞普利单抗对比含铂化疗方案一线治疗人表皮生长因子受体2（HER2）表达的局部晚期或转移性尿路上皮癌（UC）的经济性。方法采用成本-效用分析法，基于RC48-C016研究构建三状态分区生存模型，模型周期为1周，模拟DV联合特瑞普利单抗和含铂化疗方案一线治疗HER2表达的局部晚期或转移性UC的长期健康获益[质量调整生命年（QALYs）]和成本情况。模拟时限为15年，折现率为4.5%，以2025年我国人均国内生产总值（GDP）的2倍（199330元/QALY）为意愿支付（WTP）阈值，比较两组的增量成本-效果比（ICER），并开展单因素敏感性分析和概率敏感性分析。结果与含铂化疗方案相比，DV联合特瑞普利单抗方案可多获得1.01QALYs，但成本增加183224.45元，ICER为181728.15元/QALY，低于WTP阈值；在当前阈值下，DV联合方案具有成本-效用优势的概率为79.9%。结论以2倍2025年我国人均GDP为WTP阈值时，DV联合特瑞普利单抗较含铂化疗一线治疗HER2表达的局部晚期或转移性UC具有成本-效用优势。 |
| 英文摘要： | OBJECTIVE To evaluate the cost-utility of disitamab vedotin （DV） combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic urothelial carcinoma（UC） with human epidermal growth factor receptor 2 （HER2） expression from the perspective of China’s health-care system.METHODS A cost-utility analysis was performed. A three-state partitioned survival model was constructed based on the RC48-C016 trial with a 1-week cycle length. The long-term health benefits [quality-adjusted life years（QALYs）] and costs of disitamab vedotin combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic UC with HER2 expression were simulated. The simulation time horizon was set to 15 years， and the discount rate was 4.5%. The willingness-to-pay （WTP） threshold was defined as twice China’s per capita gross domestic product（GDP） in 2025 （199 330 yuan/QALY）. The incremental cost-effectiveness ratio （ICER） between the two groups was compared， and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted.RESULTS Compared with platinum-containing chemotherapy regimen， the DV plus toripalimab regimen yielded an additional 1.01 QALYs with an incremental cost of 183 224.45 yuan， and the ICER was 181 728.15 yuan/QALY， which was below the WTP threshold. At the current threshold， the probability that the DV combination regimen had a cost-utility advantage was 79.9%.CONCLUSIONS Taking twice China’s per capita GDP in 2025 as the WTP threshold， DV combined with toripalimab exhibits a cost-utility advantage over platinum-containing chemotherapy as first-line treatment for HER2-expressing locally advanced or metastatic urothelial carcinoma. |
| 期刊： | 2026年第37卷第16期 |
| 作者： | 向佩妍；张慧；张凯鑫；曾桂浩；蔡毕坤；刘宇航；胡双双；刘永辉 |
| 英文作者： | XIANG Peiyan， ZHANG Hui，ZHANG Kaixin，ZENG Guihao，CAI Bikun，LIU Yuhang，HU Shuangshuang，LIU Yonghui |
| 关键字： | 维迪西妥单抗；特瑞普利单抗；尿路上皮癌；成本-效用分析；分区生存模型 |
| KEYWORDS： | disitamab vedotin;toripalimab;urothelial carcinoma;Cost-utility analysis;partitioned survival model |
| 总下载数： | 81次 |
| 本日下载数： | 2次 |
| 本月下载数： | 81次 |
| 文件大小： | 619.60Kb |
* 注：未经本站明确许可，任何网站不得非法盗链资源下载连接及抄袭本站原创内容资源!在此感谢您的支持与合作！