瑞维鲁胺一线治疗高瘤负荷、转移性激素敏感性前列腺癌成本效用分析  

Cost-effectiveness Analysis of First-line Treatment of Large-volume,Hormone-sensitive Metastatic Prostate Cancer with Rezvilutamide

作　　者：余松林 陈秋平 李勋 YU Songlin;CHEN Qiuping;LI Xun(Second Clinical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China;First Clinical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450053,China)

机构地区：[1]河南中医药大学第二临床医学院,郑州450046 [2]河南中医药大学第一临床医学院,郑州450000 [3]河南中医药大学第二附属医院,郑州450053

出　　处：《中国现代应用药学》2024年第15期2113-2119,共7页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的分析瑞维鲁胺与比卡鲁胺联合雄激素剥夺治疗一线治疗大容量、转移性激素敏感性前列腺癌的经济性。方法从中国卫生体系角度出发,基于CHART研究数据应用Excel 2019构建无进展生存、疾病进展和死亡的三状态分区生存模型进行成本-效用分析。模型循环周期为4周,研究时限为终生,成本和效果的贴现率设定为5%。模型输出主要结果为总成本、质量调整生命年(quality-adjusted life years,QALYs)和增量成本-效果比(incremental cost-effectiveness ratio,ICER)。对模型中的重要参数进行单因素敏感性分析和概率敏感性分析。结果基础分析:与比卡鲁胺方案相比,瑞维鲁胺方案增加了2.293个QALYs,同时成本增加了519025.32元,ICER为226379.14元·QALY-1。单因素敏感性分析结果显示无进展生存状态效用值、瑞维鲁胺成本和贴现率对ICER的影响较大。概率敏感性分析显示:当意愿支付值为3倍2021年中国人均生产总值时,瑞维鲁胺成为优势方案的概率为73.8%。结论在3倍2021年中国人均生产总值的阈值下,瑞维鲁胺方案一线治疗大容量、转移性激素敏感性前列腺癌具有经济性。OBJECTIVE To analyze the economics of first-line androgen deprivation therapy combined with rezvilutamide and bicalutamide in the treatment of large-volume,metastatic,hormone-sensitive prostate cancer.METHODS From the point of view of China’s health system,a three-state partition survival model of progression-free survival,disease progression and death was constructed based on CHART data and Excel 2019 for cost-utility analysis.The cycle time of the model was 4 weeks,the duration of study was lifetime,and the discount rate of cost and effect was set at 5%.The main outputs were total cost,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER).Single factor sensitivity analysis and probability sensitivity analysis were carried out for the important parameters in the model.RESULTS Baseline analysis:compared with the bicalutamide regimen,the rezvilutamide regimen resulted in an increase of 2.293 QALYs with a concurrent cost increase of 519025.32 Yuan and an ICER of 226379.14 yuan per QALY.Univariate sensitivity analysis showed that progression-free survival status utility,cost of rezvilutamide,and discount rate had significant effects on ICER.The probability sensitivity analysis showed that when the willing to pay was 3 times the gross domestic product per 2021 of China,the probability was 73.8%.CONCLUSION The first-line treatment of high-volume,metastatic,hormone-sensitive prostate cancer with the rezvilutamide regimen is economical at a 2021 of China’s gross domestic product per capita threshold.

关 键 词：瑞维鲁胺 比卡鲁胺 激素敏感性前列腺癌 分区生存模型 质量调整生命年 增量成本-效果比 

分 类 号：R956[医药卫生—药学]