摘要
目的评估达罗他胺、雄激素剥夺治疗(ADT)和多西他赛联合治疗转移性激素敏感性前列腺癌(mHSPC)的成本-效用。方法构建三状态分区生存模型,模拟患者25年的总成本、质量调整生命年(QALYs)和增量成本-效用比(ICUR),采用单因素敏感性分析和概率敏感性分析检验模型的稳健性。结果基础分析结果显示,达罗他胺三联疗法较安慰药多获得1.93个QALYs,同时多花费443434.97元,ICUR值为230204.49元/QALY,略低于3倍人均国内生产总值;情景分析结果显示,当达罗他胺价格下降30%时,ICUR低于2倍人均国内生产总值;单因素敏感性分析显示,mHSPC状态的健康效用值和达罗他胺的成本对基础分析结果影响较大;概率敏感性分析显示,当意愿支付阈值为242928元/QALY时,达罗他胺三联疗法具有成本-效优势用的概率为63.30%。结论从中国卫生体系角度来看,达罗他胺、ADT和多西他赛联合治疗mHSPC患者更具有成本-效用优势。
Objective To evaluate the cost-utility of the combination of darolutamide,androgen-deprivation therapy(ADT),and docetaxel for treating metastatic hormone-sensitive prostate cancer(mHSPC).Methods A partitioned survival model was constructed to simulate total cost,quality-adjusted life years(QALYs),and incremental cost-utility ratio(ICUR)over a 25-year lifetime horizon.One-way sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the model.Results The base-case results showed that darolutamide yielded an additional 1.93 QALYs and an incremental cost of 443434.97 CNY.The ICUR was 230204.49 CNY/QALY,which was slightly lower than 3 times the GDP per capita.Scenario analysis showed that when the price of darolutamide fell by 30%,the ICUR was lower than two times the GDP per capita.According to the one-way sensitivity analyses,the utility of the mHSPC state and the cost of darolutamide had the most significant impact on the final result.In the probabilistic sensitivity analyses,at a willingness-to-pay threshold of 242928 CNY/QALY,the probability of darolutamide being cost-effective was 63.30%.Conclusion From the perspective of the Chinese healthcare system,the combination of darolutamide,ADT,and docetaxel was a more cost-effective treatment regimen in the treatment of mHSPC patients.
作者
刘世贤
李顺平
窦蕾
王凯旋
史钊
王瑞雪
朱晓红
宋泽华
LIU Shixian;LI Shunping;DOU Lei;WANG Kaixuan;SHI Zhao;WANG Ruixue;ZHU Xiaohong;SONG Zehua(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;NHC Key Lab of Health Economics and Policy Research(Shandong University),Jinan 250012,China;Center for Health Preference Research,Shandong University,Jinan 250012,China)
出处
《医药导报》
CAS
北大核心
2023年第9期1400-1406,共7页
Herald of Medicine
