维布妥昔单抗联合化疗方案治疗CD30阳性外周T细胞淋巴瘤的成本-效果分析  

Cost-effect analysis of velbrentuximab plus chemotherapy for CD30-positive peripheral T-cell lymphoma

作　　者：王旋辉 丁樱 张明远 李云 宫春博 WANG Xuanhui;DING Ying;ZHANG Mingyuan;LI Yun;GONG Chunbo(School of Pharmacy,Shandong University of Traditional Chinese Medicine,Shandong Jinan 250300,China;School of Management,Shandong University of Traditional Chinese Medicine,Shandong Jinan 250300,China)

机构地区：[1]山东中医药大学药学院,山东济南250300 [2]山东中医药大学管理学院,山东济南250300

出　　处：《中国医院药学杂志》2024年第17期2026-2031,共6页Chinese Journal of Hospital Pharmacy

基　　金：2021年山东省研究生教育质量提升计划项目(编号:SDYKC21053)。

摘　　要：目的:从我国卫生体系出发,探索维布妥昔单抗联合化疗对比单独化疗治疗CD30阳性外周T细胞淋巴瘤(peripheral T cell lymphoma,PTCL)患者的经济性。方法:以ECHELON-2试验及相关文献数据为基础,构建三状态分区生存模型,模型周期为21 d,模拟时限为10年。以质量调整生命年(quality-adjusted life years,QALYs)作为产出指标,评价两方案的经济性,并通过单因素敏感性和概率敏感性分析验证结果。结果:基础分析结果显示,维布妥昔单抗联合环磷酰胺、阿霉素、泼尼松(A+CHP)方案的成本与效用均高于环磷酰胺、阿霉素、长春新碱、泼尼松(CHOP)方案,ICER值为95069.05元/QALY,远低于意愿支付阈值,证明具有经济性。单因素敏感性分析结果表明成本贴现率、效用贴效率、PFS效用值、维布妥昔单抗成本等对ICER影响较大。概率敏感性分析验证了基础分析结果的稳健性。结论:在3倍2023年我国人均国内生产总值(GDP,即268047元)的支付阈值下,维布妥昔单抗联合化疗治疗CD30阳性PTCL具有经济性。OBJECTIVE To explore the pharmacoeconomics of brentuximabvedotin plus chemotherapy versus chemotherapy alone for CD30-expressing peripheral T cell lymphoma(PTCL)patients from the perspective of Chinese healthcare system.METHODS Based upon the ECHELON-2 trial and related literatures,a three-state partition survival model was constructed with a model period of 21 days and a simulation time limit of 10 years.The economics of two protocols were evaluated with quality-adjusted life years(QALYs)as output parameters.And the results were verified by univariate sensitivity and probability sensitivity analysis.RESULTS Basic analysis results revealed that cost and utility of brentuximabvedotin plus cyclophosphamide,doxorubicin,prednisone(A+CHP)protocol were higher than those of cyclophosphamide,doxorubicin,vincristine&prednisone(CHOP)protocol.The value of incremental cost-effectiveness ratio(ICER,was 95069.05 yuan/QALY).It was much lower than willing-to-pay threshold and its economy had been validated.Univariate sensitivity analysis indicated that cost discount rate,utility discount efficiency,utility value of progression-free survival(PFS)and brentuximabvedotin cost had a greater impact on ICER.Probabilistic sensitivity analysis verified the robustness of fundamental analysis results.CONCLUSION Under the condition of 3 folds payment threshold of Chinese per capita gross domestic product(GDP 268047 yuan)in 2023,brentuximabvedotin plus chemotherapy is an economical treatment of CD30-expressing PTCL.

关 键 词：维布妥昔单抗 分区生存模型 外周T细胞淋巴瘤 成本-效果分析 

分 类 号：R973[医药卫生—药品]