泽布替尼治疗复发和难治套细胞淋巴瘤的成本-效用分析  

Cost-utility analysis of Zanubrutinib in the treatment of relapsed and refractory adult mantle cell lymphoma

作　　者：石丰豪 李薇[1,2] 韩晟 SHI Fenghao;LI Wei;HAN Sheng(Academic Department,International Research Center for Medicinal Administration,Peking University,Beijing 100191,China;Department of Pharmaceutical Administration and Clinical Pharmacy of Pharmaceutical Sciences School,Peking University,Beijing 100191,China)

机构地区：[1]北京大学医药管理国际研究中心学术部,北京100191 [2]北京大学药学院药事管理与临床药学系,北京100191

出　　处：《中国研究型医院》2022年第5期29-34,共6页Chinese Research Hospitals

摘　　要：目的从中国卫生体系角度出发,比较泽布替尼和伊布替尼治疗复发和难治套细胞淋巴瘤的长期经济性。方法采用分区生存模型模拟疾病进展与转归,模型包括疾病无进展生存(PFS)、进展后生存(PPS)、死亡(Death)3种状态。模拟时间为用药开始至病死。临床参数来源于泽布替尼Ⅱ期临床研究与伊布替尼Ⅲ期临床研究。依据泽布替尼和伊布替尼的生存曲线,通过重建患者个体数据,拟合得到对应的生存函数。效用参数来源于已发表研究。成本参数中,不良事件治疗费用通过已发表文献获得;疾病管理成本,通过文献检索或计算得到;药品价格通过查询药智数据库获得。采用单因素敏感性分析和概率敏感性分析检验基础分析结果的稳健性。结果基线分析结果显示,泽布替尼组患者可获得平均3.197个质量调整生命年(QALYs)、4.335个生命年(LYs),比伊布替尼组患者高出0.350个QALYs、0.523个LYs。同时,泽布替尼组的总成本为377633.6元,较伊布替尼组减少364716.1元。泽布替尼治疗复发和难治套细胞淋巴瘤更具有经济性。敏感性分析结果显示基础分析结果的稳健性。结论泽布替尼相比伊布替尼治疗中国复发和难治套细胞淋巴瘤,更具有经济性。Objectives To compare the long-term cost-utility of Zanubrutinib and Ibrutinib in treating relapsed and refractory mantle cell Lymphoma from a Chinese health economic perspective.Methods A partitioned-survival model was used to project simulating disease progression and regression.The model consists of 3 states progression-free survival(PFS),post-progression survival(PPS),and death of the disease.The simulation time was from the start of drug administration to death.Clinical parameters were derived from the PhaseⅡclinical study of Zanubrutinib and the PhaseⅢclinical study of Ibrutinib.Survival curves for Zanubrutinib and Ibrutinib were fitted by reconstructing individual patient data to obtain the corresponding survival functions.Effectiveness parameters were derived from published studies.The cost parameters and adverse event treatment costs were obtained through published literature,disease management costs through literature searches or calculations;and drug prices were obtained by querying the YAOZH database.One-way sensitivity analysis and probabilistic sensitivity analysis were used to test the robustness of the results of the baseline analysis.Results The baseline analysis showed that the patient achieved a mean of 3.197 quality-adjusted life years(QALYs)and 4.335 life years(LYs)in the Zanubrutinib group,with incremental achieved of 0.350 QALYs and 0.523 LYs compared to Ibrutinib group.The total cost in the Zanubrutinib group was RMB 377,633.6,which was RMB 364,716.1 less than the Ibrutinib group.Zanubrutinib has a better cost-utility advantage for treating relapsed and refractory mantle cell Lymphoma.The results of the sensitivity analysis showed that the results of the base analysis were robust.Conclusions Zanubrutinib has a better cost-utility advantage over ibrutinib in treating relapsed and refractory mantle cell Lymphoma in China.

关 键 词：淋巴瘤 膜细胞 药物疗法 经济学 药学 成本及成本分析 

分 类 号：R733.1[医药卫生—肿瘤]