摘要
目的评估阿瑞匹坦注射液与注射用福沙匹坦双葡甲胺相比预防中、高度致吐性化疗相关性恶心呕吐(CINV)的经济性。方法从中国卫生体系角度出发,构建包括急性期完全反应(CR)、急性期不完全反应(IR)、延迟期CR和延迟期IR 4个健康状态的决策树模型进行成本-效果分析,将增量成本-效果比(ICER)与意愿支付(WTP)阈值进行比较,评价阿瑞匹坦注射液相较于注射用福沙匹坦双葡甲胺预防中、高度致吐性CINV的经济性。采用单因素敏感性分析和概率敏感性分析考察参数的不确定性。结果基线分析结果显示,阿瑞匹坦注射液(139元/130 mg)比注射用福沙匹坦双葡甲胺(136元/150 mg)增加了0.00049质量调整生命年(QALYs),相应的总成本减少了299元,阿瑞匹坦注射液具有经济性。单因素敏感性分析结果显示,对ICER影响最大的参数是阿瑞匹坦注射液CR状态的效用值。概率敏感性分析结果显示,当WTP阈值为85698元/QALY时,阿瑞匹坦注射液具有经济性的概率为99%。结论阿瑞匹坦注射液价格为139元/130 mg时,是一种安全、有效、经济和方便的中、高度致吐性CINV预防药物。
Objective To evaluate the economics of Aprepitant injection compared with Foxapitan Dimegraumine for injection in the prevention of moderate and high emetogenic chemotherapy-associated nausea and vomiting(CINV).Methods From the perspective of the Chinese healthcare system,we constructed a decision tree model incorporating four health states-complete response(CR)in the acute phase,incomplete response(IR)in the acute phase,CR in the delayed phase,and IR in the delayed phase-to conduct a cost-effectiveness analysis.The incremental cost-effectiveness ratio(ICER)was compared against the willingness-to-pay(WTP)threshold to evaluate the economic value of Aprepitant Injection versus Fosaprepitant Dimeglumine for Injection in preventing moderate-to-high emetogenic chemotherapy-induced nausea and vomiting(CINV).Both one-way sensitivity analysis and probabilistic sensitivity analysis were employed to assess parameter uncertainties.Results Base-case analysis revealed that Aprepitant Injection(¥139 per 130 mg)provided an incremental gain of 0.00049 quality-adjusted life-years(QALYs)compared to Fosaprepitant Dimeglumine for Injection(¥136 per 150 mg),while reducing total costs by¥299.Demonstrating the cost-effectiveness of Aprepitant Injection.One-way sensitivity analysis identified the utility value of the complete response(CR)state with Aprepitant Injection as the most influential parameter on ICER.Probabilistic sensitivity analysis further indicated a 99%probability of Aprepitant Injection being cost-effective at a WTP threshold of¥85698 per QALY.Conclusion Aprepitant injection is a safe,effective,economical and convenient prevention of moderately and highly emetogenic CINV when the price is reduced to RMB 139/130 mg.
作者
向衡
王李婷
彭烨
孟科辉
谭重庆
XIANG Heng;WANG Li-Ting;PENG Ye;MENG Ke-Hui;TAN Chong-Qing(Department of Pharmacy,The Second Xiangya Hospital,Central South University,Changsha 410011,China)
出处
《中国药物经济学》
2025年第4期15-21,28,共8页
China Journal of Pharmaceutical Economics
