贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌的成本-效用分析-中国药房

贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌的成本-效用分析

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篇名：	贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌的成本-效用分析
TITLE：	Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer
摘要：	目的从中国卫生体系角度出发，评估贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌（ES-SCLC）的经济性。方法根据ETER701研究数据构建分区生存模型，循环周期为3周，模拟ES-SCLC患者采用贝莫苏拜单抗联合安罗替尼和化疗方案或单纯化疗方案治疗10年的总成本、质量调整生命年（QALY）及增量成本-效果比（ICER），并采用单因素敏感性分析和概率敏感性分析验证模型的稳健性。意愿支付（WTP）阈值为3倍2023年我国人均国内生产总值（GDP），即268074元/QALY。结果相比于单纯化疗方案，贝莫苏拜单抗联合安罗替尼和化疗方案可多获得0.438QALY，成本则高出403505.55元，ICER为922031.37元/QALY，高于本研究设定的WTP阈值。单因素敏感性分析结果显示，贝莫苏拜单抗成本、无进展生存期状态的效用值及贴现率对基础分析结果的影响较大；概率敏感性分析结果证实该模型稳健，且贝莫苏拜单抗降价75.4%时，联合方案才具有经济性。结论从我国卫生体系角度出发，贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗ES-SCLC当前不具有经济性。
ABSTRACT：	OBJECTIVE To evaluate the cost-utility of benmelstobart combined with anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer （ES-SCLC） from the perspective of China’s healthcare system. METHODS Based on the data from the ETER 701 study， a partitioned survival model was constructed with a cycle of 3 weeks to simulate the total cost， quality-adjusted life years （QALY）， and incremental cost-effectiveness ratio （ICER） over 10 years for patients with ES- SCLC treated with benmelstobart plus anlotinib and chemotherapy， or chemotherapy alone. One-way sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the simulation results. The willingness-to-pay （WTP） threshold was set at 3 times the per capita gross domestic product （GDP） of China in 2023， which amounted to 268 074 yuan/QALY. RESULTS Compared with chemotherapy alone， benmelstobart combined with anlotinib and chemotherapy gained 0.438 QALY more at the cost of 403 505.55 yuan more， with an ICER of 922 031.37 yuan/QALY， which was higher than the WTP threshold set in this study. One-way sensitivity analysis showed that benmelstobart’s cost and utility value of the progression-free survival state had a greater impact on the ICER value； probabilistic sensitivity analysis confirmed the robustness of the model； only when the price of benmelstobart was reduced by 75.4%， the combined regimen would be cost-effective. CONCLUSIONS The first-line treatment of ES-SCLC with benmelstobart combined with anlotinib and chemotherapy is not cost-effective from the perspective of China’s healthcare system at present.
期刊：	2025年第36卷第05期
作者：	冯冰；高宁；高胜男；张羽曦；张冉冉；刘国强
AUTHORS：	FENG Bing，GAO Ning，GAO Shengnan，ZHANG Yuxi，ZHANG Ranran，LIU Guoqiang
关键字：	贝莫苏拜单抗；安罗替尼；广泛期小细胞肺癌；分区生存模型；成本-效用分析；药物经济学
KEYWORDS：	benmelstobart； anlotinib； extensive-stage small cell lung cancer； partitioned survival model； cost-utility analysis；
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