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派安普利单抗一线治疗晚期鳞状非小细胞肺癌的药物经济学评价
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| 篇名： | 派安普利单抗一线治疗晚期鳞状非小细胞肺癌的药物经济学评价 |
| TITLE： | Pharmacoeconomic evaluation of penpulimab in first-line treatment of advanced squamous non-small-cell lung cancer |
| 摘要： | 目的 评价派安普利单抗联合化疗方案一线治疗晚期鳞状非小细胞肺癌（以下简称“肺鳞癌”）的经济性。方法从我国卫生体系角度出发，运用成本-效用分析法评估派安普利单抗联合化疗（紫杉醇+卡铂）方案相较于标准化疗（紫杉醇+卡铂）方案一线治疗晚期肺鳞癌的经济性。使用R语言构建一个三健康状态Markov模型，模型中所需的临床数据提取自AK105-302研究，成本和效用来自开放数据库和已发表的文献。效用指标为质量调整生命年（QALY），意愿支付（WTP）阈值为2024年我国人均国内生产总值（GDP）的3倍，即287247元/QALY。通过比较两种方案的增量成本-效果比（ICER）与WTP阈值的大小评估方案的经济性；使用单因素敏感性分析和概率敏感性分析验证基础分析的稳健性。结果派安普利单抗联合化疗方案较标准化疗方案增加了0.73QALY，但同时成本增加150681.93元，ICER为206413.60元/QALY。单因素敏感性分析显示，无进展生存（PFS）状态的效用值对ICER的影响最大。概率敏感性分析显示，WTP阈值为3倍的2024年我国人均GDP时，派安普利单抗联合化疗方案具有经济性的概率为98.80%；但当WTP阈值降低为1倍我国人均GDP时，派安普利单抗联合化疗方案具有经济性的概率＜0.01%。结论对于晚期肺鳞癌，当WTP阈值为3倍的2024年我国人均GDP时，派安普利单抗联合化疗是一种具有经济性的一线治疗方案。 |
| ABSTRACT： | OBJECTIVE To estimate the cost-effectiveness of penpulimab combined with chemotherapy versus chemotherapy alone in first-line treatment of advanced squamous non-small-cell lung cancer （sq-NSCLC）. METHODS From the perspective of Chinese health system， cost-utility analysis was used to evaluate the cost-effectiveness of penpulimab combined with chemotherapy （paclitaxel + carboplatin） versus chemotherapy （paclitaxel + carboplatin） in first-line treatment of sq-NSCLC. A three-health states Markov model was constructed with R packages， and clinical data used in the model were derived from the AK105-302 clinical trial. Costs and utilities were collected from the open-access database and published literature. The quality-adjusted life-years （QALY） was used as the utility index， and the willingness-to-pay （WTP） threshold was set at three times China’s per capita GDP in 2024， equivalent to 287 247 yuan/QALY. The cost-effectiveness of the schemes was evaluated by comparing the incremental cost- utility ratios （ICER） of the two schemes with the WTP threshold. One-way sensitivity analysis and probabilistic sensitivity analysis （PSA） were used to verify the stability of the basic analysis results. RESULTS Compared with chemotherapy， penpulimab combined with chemotherapy increased 0.73 QALY with an incremental cost of 150 681.93 yuan， and the ICER was 206 413.60 yuan/QALY. One-way sensitivity analysis showed that the utility of progression-free survival was the most sensitive factor on ICERs. At the WTP threshold of 3 times China’s per capita GDP， the economic probability of this scheme was 98.80%. At the WTP threshold of 1 times China’s per capita GDP， the probability of ICER being cost-effective was less than 0.01%. CONCLUSIONS For patients with advanced sq-NSCLC， penpulimab combined with chemotherapy is a cost-effective first-line treatment option when WTP threshold is 3 times China’s per capita GDP. |
| 期刊： | 2025年第36卷第11期 |
| 作者： | 胡冬雪；郑颖；高倩；胡世远；王丹凤；于芳珠；东蕾 |
| AUTHORS： | HU Dongxue，ZHENG Ying，GAO Qian，HU Shiyuan，WANG Danfeng，YU Fangzhu，DONG Lei |
| 关键字： | 派安普利单抗；晚期鳞状非小细胞肺癌；药物经济学；成本-效用分析；Markov模型 |
| KEYWORDS： | penpulimab； advanced squamous non-small-cell lung cancer； pharmacoeconomics； cost-utility analysis； Markov |
| 阅读数： | 12 次 |
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