卡介苗用于我国中高危非肌层浸润性膀胱癌患者TUR-BT术后灌注治疗的药物经济学评价  

Pharmacoeconomic evaluation of Bacillus Calmette-Guérin for post-TUR-BT perfusion therapy in patients with intermediate-to high-risk non-muscle invasive bladder cancer in China

作　　者：苏志铖 李璐 姚强 朱彩蓉[1] 贾涛 SU Zhicheng;LI Lu;YAO Qiang;ZHU Cairong;JIA Tao(Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Chengdu Rongsheng Pharmaceuticals Co.,Ltd.,Chengdu 610093,China;China National Biotech Co.,Ltd.,Beijing 100011,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院流行病与卫生统计学系,成都610041 [2]成都蓉生药业有限责任公司,成都610093 [3]中国生物技术股份有限公司,北京100011

出　　处：《中国药房》2024年第22期2773-2778,共6页China Pharmacy

基　　金：国家自然科学基金项目(No.82173618)。

摘　　要：目的对卡介苗(BCG)与表柔比星用于中高危非肌层浸润性膀胱癌(NMIBC)患者经尿道膀胱肿瘤切除术(TUR-BT)术后膀胱灌注治疗的经济性进行评价。方法从我国卫生体系角度出发,基于ChiCTR-IIR-16008357研究构建Markov队列模型。以质量调整生命年(QALYs)作为健康产出,意愿支付阈值设定为1倍2023年中国人均国内生产总值(89358元/QALY)。采用成本-效用分析比较BCG方案相对表柔比星方案用于我国中高危NMIBC患者TUR-BT术后膀胱灌注治疗的增量成本-效果比(ICER),并进行敏感性分析。结果BCG方案相比于表柔比星方案的增量成本为34309.51元,增量效用为0.800 QALYs,ICER为42871.33元/QALY,低于意愿支付阈值。当意愿支付阈值为89358元/QALY时,概率敏感性分析中BCG方案可被接受的概率为77.70%,高于表柔比星方案,且BCG方案的可接受性随意愿支付阈值的增加而增加。结论以1倍2023年我国人均GDP为意愿支付阈值时,相比表柔比星,BCG用于中高危NMIBC患者TUR-BT术后膀胱灌注治疗具有更好的经济性。OBJECTIVE To evaluate the cost-effectiveness of using Bacillus Calmette-Guérin(BCG)versus epirubicin for intravesical perfusion after transurethral resection of bladder tumor(TUR-BT)in patients with intermediate-to high-risk non-muscleinvasive bladder cancer(NMIBC).METHODS From the perspective of China’s health system,a Markov cohort model was constructed based on the ChiCTR-IIR-16008357 study.Quality-adjusted life years(QALYs)were used as the health outcome measure,with the willingness-to-pay(WTP)threshold set at one time the per capita gross domestic product of China in 2023(89358 yuan/QALY).A cost-utility analysis was used to compare the incremental cost-effectiveness ratio(ICER)of the BCG regimen relative to the epirubicin regimen for intravesical perfusion after TUR-BT in patients with intermediate-to high-risk NMIBC in China.In addition,sensitivity analysis was performed.RESULTS The incremental cost of the BCG regimen compared to the epirubicin regimen was 34309.51 yuan,with an incremental utility of 0.800 QALYs,resulting in an ICER of 42871.33 yuan/QALY,which is below the WTP threshold.When the WTP threshold was 89358 yuan/QALY,the probability that the BCG regimen would be acceptable was 77.70%in the probabilistic sensitivity analysis,higher than that of the epirubicin regimen,and the acceptability of the BCG regimen increased with increasing in the WTP threshold.CONCLUSIONS When the WTP threshold was set at one time the per capita gross domestic product of China in 2023,compared to epirubicin,BCG used for intravesical perfusion after TUR-BT in patients with intermediate-to highrisk NMIBC demonstrated better cost-effectiveness.

关 键 词：卡介苗 非肌层浸润性膀胱癌 经尿道膀胱肿瘤切除术 膀胱灌注 表柔比星 药物经济学 

分 类 号：R956[医药卫生—药学]