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替雷利珠单抗治疗局部晚期或转移性（非）鳞状NSCLC的成本-效用分析
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| 篇名： | 替雷利珠单抗治疗局部晚期或转移性（非）鳞状NSCLC的成本-效用分析 |
| TITLE： | Cost-utility analysis of tislelizumab in the treatment of locally advanced or metastatic （non-）squamous NSCLC |
| 摘要： | 目的 从我国卫生体系角度出发，评价替雷利珠单抗单药治疗既往接受过含铂双药方案化疗后疾病进展或不可耐受的局部晚期或转移性鳞状或非鳞状非小细胞肺癌（NSCLC）患者的经济性。方法根据Rationale-303研究数据构建分区生存模型，设定模型周期为21d，模拟时间为120个月。以质量调整生命年（QALY）为健康产出指标，采用5%的贴现率对成本和健康产出进行贴现，计算增量成本-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基础分析结果的稳健性。结果成本-效用分析结果显示，替雷利珠单抗组方案相对于多西他赛组方案的ICER为65653.52元/QALY，即当意愿支付阈值（WTP）为3倍2023年我国人均国内生产总值（268200元/QALY）时，替雷利珠单抗组方案比多西他赛组方案更具有经济性。单因素敏感性分析结果显示，对ICER影响程度较大的3个参数分别是替雷利珠单抗成本、多西他赛成本、培美曲塞成本。概率敏感性分析结果显示，当WTP阈值约为65000元/QALY时，上述两组治疗方案具有经济性的概率均为50%；当WTP阈值≥134000元/QALY时，替雷利珠单抗组方案具有经济性的概率为100%。结论从我国卫生体系角度出发，以3倍2023年我国人均国内生产总值作为WTP阈值时，与多西他赛相比，替雷利珠单抗单药治疗既往接受过含铂双药方案化疗后疾病进展或不可耐受的局部晚期或转移性鳞状或非鳞状NSCLC患者具有经济性。 |
| ABSTRACT： | OBJECTIVE From the perspective of China’s healthcare system， to evaluate the cost-effectiveness of tislelizumab in patients with locally advanced or metastatic squamous or non-squamous non-small cell lung cancer （NSCLC） whose disease progresses or is intolerable after receiving platinum-containing dual chemotherapy in the past. METHODS Rationale-303 research data were used to construct a partitioned survival model. The model period was set to be 21 days and simulated to 120 months. Using quality-adjusted life year （QALY） as a health output index， the incremental cost-effectiveness ratio （ICER） was calculated by discounting cost and health output with a discount rate of 5%. Single-factor sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the basic analysis results. RESULTS Cost-utility analysis results showed that the ICER of tislelizumab group was 65 653.52 yuan/QALY， compared with docetaxel group. This means that the regimen of tislelizumab was more cost-effective than the docetaxel regimen when the willingness-to-pay threshold （WTP） was 3 times China’s gross domestic product （GDP） per capita in 2023 （268 200 yuan/QALY）. The results of single-factor sensitivity analysis showed that the three parameters that had a greater impact on ICER were the prices of tislelizumab， docetaxel and pemetrexed. The results of the probabilistic sensitivity analysis showed that the probabilities of the above two treatment regimens being cost-effective were both 50% when the WTP threshold was approximately 65 000 yuan/QALY. The probability of tislelizumab regimen being cost- effective was 100% when the WTP threshold was ≥134 000 yuan/QALY. CONCLUSIONS From the perspective of China’s healthcare system， when taking 3 times China’s GDP per capita in 2023 as the WTP threshold， tislelizumab is cost-effective for patients with locally advanced or metastatic squamous or non-squamous NSCLC after receiving platinum-containing dual chemotherapy in the past， compared with docetaxel. |
| 期刊： | 2025年第36卷第11期 |
| 作者： | 王春燕；吴婧；沈丽霞 |
| AUTHORS： | WANG Chunyan，WU Jing，SHEN Lixia |
| 关键字： | 替雷利珠单抗；非小细胞肺癌；分区生存模型；成本-效用分析 |
| KEYWORDS： | tislelizumab； non-small cell lung cancer； partitioned survival model； cost-utility analysis |
| 阅读数： | 9 次 |
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