安罗替尼治疗晚期非小细胞肺癌的成本效果分析  

Cost-effectiveness analysis of anlotinib in treating advanced non-small cell lung cancer

作　　者：张晋[1] 任立红[2] 刘冬[1] 刘子昀 张晓钰[1] 乌伊萍 杨蓓蓓 姜凤丽[1] ZHANG Jin;REN Li-hong;LIU Dong;LIU Zi-yun;ZHANG Xiao-yu;WU Yi-ping;YANG Bei-bei;JIANG Feng-li(Department of Clinical Pharmacy,Baoji Central Hospital,Baoji SHAANXI 721008,China;Inspection Teaching and Research Office,Baoji Vocational Technical College,Baoji SHAANXI 721013,China)

机构地区：[1]宝鸡市中心医院临床药学室,陕西宝鸡721008 [2]宝鸡职业技术学院检验教研室,陕西宝鸡721013

出　　处：《中国新药与临床杂志》2020年第6期380-384,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的对安罗替尼三线治疗晚期非小细胞肺癌(NSCLC)进行成本效果分析。方法建立动态Markov模型,模拟患者终生的直接医疗成本和质量调整生命年(QALYs)。依据ALTER 0303临床研究数据,采用成本效果分析法,以增量成本效果比(ICER)为评价指标,评价安罗替尼作为NSCLC三线治疗方案的成本效果,并进行敏感性分析。结果与安慰剂组相比,安罗替尼组的生命年(LYs)和QALYs分别提高了0.173 LYs和0.207QALYs;终生费用提高48895元,ICER值为236208元·QALY-1。敏感性分析结果显示安罗替尼在整体中国人群中具有成本效果优势的概率为4.3%,但在北京、上海等经济发达地区具有成本效果优势的概率为100%。结论安罗替尼能延长晚期NSCLC患者的LYs和QALYs,同时也增加了医疗成本。其在整体中国人群中不具有成本效果优势,但在北京、上海等经济发达地区具有成本效果优势。AIM To analyze the cost-effectiveness of anlotinib as the third-line therapy in advanced non-small cell lung cancer(NSCLC).METHODS A dynamic Markov model was built to simulate the direct medical costs and qualityadjusted life year(QALYs)in NSCLC patients.According to the clinical data of ALTER 0303,the cost-effectiveness analysis was used to estimate the cost-effectiveness of anlotinib as the third-line therapy,which used the incremental costeffectiveness ratio(ICER)as the evaluation indicator,and sensitivity analysis was carried out.RESULTS Compared to the placebo group,the LYs and QALYs of the anlotinib group increased by 0.173 LYs and 0.207 QALYs.The lifetime cost increased by 48895 Yuan,and the ICER value was 236208 Yuan·QALY-1.The results showed that the probability of cost-effectiveness advantage of anlotinib in the overall Chinese population was 4.3%,but which in Beijing and Shanghai was 100%by sensitivity analysis.CONCLUSION Anlotinib can prolong the LYs and QALYs of advanced NSCLC patients,and also increase the medical costs.It has not a cost-effective advantage for overall Chinese population,but it has a cost-effective advantage in some economically developed regions such as Beijing and Shanghai.

关 键 词：癌 非小细胞肺 安罗替尼 成本效用分析 药物经济学 MARKOV模型 

分 类 号：R956[医药卫生—药学] R979.1