摘要
目的从卫生体系角度出发,探讨特瑞普利单抗(Toripalimab)和安慰剂联合吉西他滨和顺铂(GP)治疗复发或转移性鼻咽癌(RM-NPC)的药物经济学评价。方法根据Ⅲ期临床试验研究结果,建立Markov模型,评价特瑞普利珠单抗联合GP(TGP)与安慰剂联合GP(PGP)方案治疗RM-NPC的成本效果,贴现率为5%,对结果数据进行了单因素、概率敏感性分析。结果TGP疗法与PGP疗法的增量-成本效用比(ICUR)为216545.0917元/QALY,低于我国3倍人均GDP的意愿支付值(WTP)242928元/QALYs,而单因素敏感性分析显示,无进展生存期(PFS)状态的健康效用值和特瑞普利单抗成本对结果影响最大,效用值的降低可能会使ICER高于设定的WTP阈值,导致TGP方案不再具有经济学优势。结论以3倍人均GDP为意愿支付阈值,与PGP方案相比,TGP方案治疗局部复发或转移性鼻咽癌具有经济性。
OBJECTIVE To investigate the pharmacoeconomic evaluation of Toripalimab and placebo combined with Gemcitabine and Cisplatin(GP)in the treatment of recurrent or metastatic nasopharyngeal carcinoma(RM-NPC)from the perspective of health system.METHODS Based on the results of phaseⅢclinical trials,Markov model was established to evaluate the cost-effectiveness of teriplizumab combined GP(TGP)and placebo combined GP(PGP)in the treatment of RM-NPC.The discount rate was 5%,and univariate and probabilistic sensitivity analysis was performed on the result data.RESULTS The incremental cost-utility ratio(ICUR)of TGP therapy and PGP therapy was 216545.0917 yuan/QALY,which was lower than the value of willing to pay(WTP)of 242928 yuan/QALYs of 3 times per capita GDP.The health utility value of Progression-free survival(PFS)state and the cost of riplelimab have the greatest influence on the results.The decrease of utility value may make ICER higher than the set WTP threshold,resulting in the economic advantage of TGP scheme.CONCLUSION With 3 times GDP per capita as the willing payment threshold,TGP is economical compared with PGP in the treatment of local recurrent or metastatic nasopharyngeal carcinoma.
作者
谢欣彤
孙国君
董作军
张少雅
XIE Xin-tong;SUN Guo-jun;DONG Zuo-jun;ZHANG Shao-ya(Zhejiang University of Technology,Huzhou 313200,China)
出处
《海峡药学》
2023年第7期56-60,共5页
Strait Pharmaceutical Journal
基金
浙江省疫苗供应链安全监管风险要素识别评价及预警研究(编号:2020C35045)。
关键词
特瑞普利
吉西他滨-顺铂
鼻咽癌
药物经济学
Toripalimab
Gend Cisplatin
Nasopharyngeal carcinoma
Pharmacoeconomics
