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信迪利单抗联合化疗方案一线治疗晚期、复发或转移性食管鳞状细胞癌的成本-效用分析
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| 篇名： | 信迪利单抗联合化疗方案一线治疗晚期、复发或转移性食管鳞状细胞癌的成本-效用分析 |
| TITLE： | Cost-utility analysis of sintilimab combined with chemotherapy in first-line treatment of advanced，recurrent or metastatic esophageal squamous cell carcinoma |
| 摘要： | 目的 从我国卫生体系角度评价信迪利单抗联合化疗方案对比单用化疗方案一线治疗晚期、复发或转移性食管鳞状细胞癌（ESCC）的经济性，为临床合理用药提供参考。方法基于ORIENT-15研究数据，使用TreeAgePro2011软件建立具有无进展生存（PFS）、疾病进展和死亡三状态的Markov模型进行成本-效用分析，模型周期为3周，研究时限为10年，贴现率为5%。模型输出主要结果为总成本、质量调整生命年（QALY）和增量成本-效果比（ICER）。以1～3倍2021年我国人均国内生产总值（GDP）为意愿支付（WTP）阈值。参数的不确定性采用单因素敏感性分析和概率敏感性分析，并探讨上述2种方案在不同的贴现率、对比其他同类治疗方案和有慈善赠药方案3种情境下的经济性。结果基础分析结果显示，与单用化疗方案相比，信迪利单抗联合化疗方案的ICER为64208.75元/QALY，小于WTP阈值。单因素敏感性分析结果显示，PFS状态效用值、信迪利单抗周期成本和贴现率对结果的影响相对较大。概率敏感性分析结果显示，当WTP阈值≥120000元时，信迪利单抗联合化疗方案具有经济性的概率为100%。情境分析结果显示，3种情境下的信迪利单抗联合化疗方案均较单用化疗方案更具有经济性。结论信迪利单抗联合化疗方案相较于单用化疗方案一线治疗晚期、复发或转移性ESCC更具有经济性。 |
| ABSTRACT： | OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with chemotherapy than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic esophageal squamous cell carcinoma （ESCC） from the perspective of health system of our country， and provide reference for rational use of drug in clinic. METHODS Based on ORIENT-15 study data， TreeAge Pro 2011 software was used to establish a three-state Markov model of non-progressive survival （PFS）， disease progression and death for cost-utility analysis. The model period was 3 weeks， the research time limit was 10 years， and the discount rate was 5%. The main outputs of the model were total cost， quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER）. The 1-3 times of China’s GDP per capita in 2021 was taken as the threshold of willing- ness to pay （WTP）. The uncertainty of the parameters was analyzed by single factor sensitivity analysis and probability sensitivity analysis， and the cost-effectiveness of the two schemes was discussed under three situations： different discount rates， comparison with other similar treatment schemes and charitable drug donation schemes. RESULTS The results of basic analysis showed that compared with chemotherapy plan alone， the ICER of sintilimab combined with chemotherapy was 64 208.75 yuan/QALY， which was less than WTP threshold. The results of single factor sensitivity analysis show that PFS state utility value， cycle cost of sintilimab and discount rate had relatively great influence on the results. Probability sensitivity analysis showed that when WTP≥120 000 yuan， the economic probability of sintilimab combined with chemotherapy plan was 100%. The results of situational analysis showed that sintilimab combined chemotherapy was more cost- effective than single-use chemotherapy. CONCLUSIONS Sintilimab combined with chemotherapy is more cost-effective than single-use chemotherapy in the first-line treatment of advanced， recurrent or metastatic ESCC. |
| 期刊： | 2023年第34卷第03期 |
| 作者： | 陈秋平；邵明义；张容容；陈晓琦 |
| AUTHORS： | CHEN Qiuping，SHAO Mingyi，ZHANG Rongrong，CHEN Xiaoqi |
| 关键字： | 信迪利单抗；食管鳞状细胞癌；紫杉醇；顺铂；成本-效用分析；药物经济学 |
| KEYWORDS： | sintilimab； esophageal squamous cell carcinoma； paclitaxel； cisplatin； cost-utility analysis； pharmacoeconomics |
| 阅读数： | 185 次 |
| 本月下载数： | 6 次 |
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