摘要
目的对比替雷利珠单抗与索拉非尼用于治疗一线治疗晚期不可切除肝细胞癌的成本-效用,从药物经济学的角度为治疗方案选择提供参考。方法采用分区生存模型,模拟10年内患者使用替雷利珠单抗或者索拉非尼的生存状态,分别计算成本和健康产出,获得增量成本效用比(ICUR)。以3倍的2022年我国人均国内生产总值(GDP)为意愿支付阈值(WTP)。结果在模拟期限内,替雷利珠单抗与索拉非尼方案ICUR为280691.4元/质量调整生命年(QALY),显著高于索拉非尼组,具有明显的经济性。单因素敏感性分析显示,替雷利珠单抗组三级以上不良反应发生率、替雷利珠单抗费用,索拉非尼组三级以上不良反应发生率是影响ICUR的重要因素。概率敏感性分析显示,在WTP为3倍GDP时,替雷利珠单抗有显著成本-效用优势,经济概率为81.4%,结果稳健。结论对于一线治疗晚期不可切除肝细胞癌,替雷利珠单抗比索拉非尼具有显著成本-效用优势。
Objective To compare the cost-utility of tislelizumab and sorafenib in the first-line treatment of advanced unresectable hepatocellular carcinoma,and to provide a reference for the selection of treatment regimens from the perspective of pharmacoeconomics.Methods A partitioned survival model was used to simulate the survival status of patients using tislelizumab or sorafenib within 10 years,and the cost and health output were calculated respectively to obtain the incremental cost-utility ratio(ICUR).The 3 times China's per capita gross domestic product(GDP)in 2022 was taken as the threshold for willingness to pay(WTP).Results During the simulation period,the ICER of tislelizumab versus sorafenib was 280691.4 yuan/quality-adjusted life year(QALY),which was significantly higher than that of the sorafenib group,which had obvious economic performance.Univariate sensitivity analysis showed that the incidence of grade 3 or above adverse reactions in the tislelizumab group,the cost of tislelizumab,and the incidence of grade 3 or higher adverse reactions in the sorafenib group were important factors affecting ICUR.Probabilistic sensitivity analysis showed that tislelizumab had a significant cost-utility advantage when WTP was 3 times GDP,with an economic probability of 81.4%,and the results were robust.Conclusion For the first-line treatment of advanced unresectable hepatocellular carcinoma,tislelizumab has a significant cost-utility advantage over sorafenib.
作者
苏展
车金辉
裴锐锋
SU Zhan;CHE Jinhui;PEI Ruifeng(Department of Hepatobiliary Pancreatic Surgery,Xuzhou Cancer Hospital,Xuzhou 221000,Jiangsu Province,China)
出处
《中国药师》
CAS
2024年第1期109-116,共8页
China Pharmacist
基金
徐州市卫生健康委科技项目(XWKYSL20220353)。
