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替雷利珠单抗联合化疗一线治疗局部晚期不可切除或转移性胃或胃食管结合部腺癌的成本-效果分析
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| 篇名： | 替雷利珠单抗联合化疗一线治疗局部晚期不可切除或转移性胃或胃食管结合部腺癌的成本-效果分析 |
| TITLE： | Cost-effectiveness analysis of tislelizumab combined with chemotherapy as first-line treatment for locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma |
| 摘要： | 目的 评价替雷利珠单抗联合化疗一线治疗局部晚期不可切除或转移性胃或胃食管结合部腺癌的经济性。方法从我国卫生体系角度出发，利用RATIONALE-305试验和相关文献数据建立分区生存模型，循环周期为3周，模拟时限为10年，贴现率为5%。以质量调整生命年（QALYs）为健康产出指标，评价替雷利珠单抗联合化疗对比安慰剂联合化疗一线治疗局部晚期不可切除或转移性胃或胃食管结合部腺癌的经济性，并进行单因素敏感性分析和概率敏感性分析。结果基础分析结果显示，与安慰剂联合化疗相比，替雷利珠单抗联合化疗方案可使患者多获得0.268QALYs，但治疗成本会增加70404.81元，增量成本-效果比（ICER）为262431.62元/QALY，低于3倍2023年我国人均国内生产总值（GDP）的意愿支付阈值（268074元/QALY）。单因素敏感性分析结果显示，无进展生存效用值和替雷利珠单抗药品成本对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2023年我国人均GDP时，替雷利珠单抗具有经济性的概率为53.3%。结论当WTP阈值为3倍2023年我国人均GDP时，与安慰剂联合化疗方案相比，替雷利珠单抗联合化疗一线治疗局部晚期不可切除或转移性胃或胃食管结合部腺癌具有经济性。 |
| ABSTRACT： | OBJECTIVE To evaluate the cost-effectiveness of tislelizumab combined with chemotherapy as first-line treatment for locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma. METHODS The data of RATIONALE-305 study and related literature were used to establish a partitioned survival model from the perspective of China’s health system. The cycle was 3 weeks， the simulation time was set as 10 years， and the discount rate was 5%. The quality-adjusted life years （QALYs） were used as the health outcome indicator to evaluate the cost-effectiveness of tislelizumab combined with chemotherapy versus placebo combined with chemotherapy as first-line treatment for locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma， and one-way sensitivity analysis and probabilistic sensitivity analysis were also conducted. RESULTS The base analysis showed that the patients received more 0.268 QALYs with tislelizumab plus chemotherapy， compared with placebo plus chemotherapy， but the cost increased by 70 404.81 yuan with an incremental cost- effectiveness ratio （ICER） of 262 431.62 yuan/QALY， which was less than three times China’s gross domestic product （GDP） per capita in 2023 as the willingness-to-pay （WTP） threshold （268 074 yuan/QALY）. One-way sensitivity analysis showed that the efficacy value of progress free survive and the price of tislelizumab had a greater impact on the ICER value. The results of probability sensitivity analysis showed that when the WTP threshold was 3 times China’s GDP per capita in 2023， the probability of tislelizumab being cost-effective was 53.3%. CONCLUSIONS When the WTP threshold is 3 times China’s GDP per capita in 2023， tislelizumab plus chemotherapy is cost-effective for first-line treatment of locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma， compared with placebo plus chemotherapy. |
| 期刊： | 2024年第35卷第08期 |
| 作者： | 冯冰；高宁；高胜男；郭珊；牛梦娜；刘国强 |
| AUTHORS： | FENG Bing，GAO Ning，GAO Shengnan，GUO Shan，NIU Mengna，LIU Guoqiang |
| 关键字： | 替雷利珠单抗；胃或胃食管结合部腺癌；一线治疗方案；成本-效果分析 |
| KEYWORDS： | tislelizumab； gastric or gastroesophageal junction |
| 阅读数： | 22 次 |
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