特瑞普利单抗联合紫杉醇治疗转移性或复发性三阴性乳腺癌的成本-效果分析  

Cost-effectiveness analysis of toripalimab combined with paclitaxel in the treatment of metastatic or recurrent triple-negative breast cancer

作　　者：闫文英 陶心悦 冯冰 YAN Wenying;TAO Xinyue;FENG Bing(Dept.of Clinical Pharmacy,Hebei Medical University Third Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院临床药学部,石家庄050051

出　　处：《中国药房》2025年第3期336-340,共5页China Pharmacy

基　　金：河北省医学科学研究课题计划(No.20211783)。

摘　　要：目的 评价特瑞普利单抗联合紫杉醇(白蛋白结合型)治疗转移性或复发性三阴性乳腺癌(TNBC)的经济性。方法 根据TORCHLIGHT试验数据,建立包括无进展生存、疾病进展和死亡的三状态分区生存模型,模拟周期为21 d,研究时限为10年,贴现率为5%,以质量调整生命年(QALY)和成本为产出指标,采用成本-效果分析法计算特瑞普利单抗联合紫杉醇(白蛋白结合型)相比安慰剂联合紫杉醇(白蛋白结合型)的增量成本-效果比(ICER)。以3倍我国2023年人均国内生产总值(GDP)为意愿支付(WTP)阈值(268 074元/QALY),评价上述两种方案的经济性,并进行敏感性分析。结果 特瑞普利单抗联合紫杉醇(白蛋白结合型)对比安慰剂联合紫杉醇(白蛋白结合型)治疗我国转移性或复发性TNBC患者的ICER为176 347.17元/QALY,低于本研究设定的WTP阈值,证明该方案具有经济性。单因素敏感性分析结果显示,特瑞普利单抗成本、贴现率、无进展生存状态效用值等参数对ICER的影响较大;概率敏感性分析结果表明基础分析结果稳健。结论 以3倍我国2023年人均GDP作为WTP阈值时,相比安慰剂联合紫杉醇(白蛋白结合型)方案,特瑞普利单抗联合紫杉醇(白蛋白结合型)治疗转移性或复发性TNBC具有经济性。OBJECTIVE To evaluate the cost-effectiveness of toripalimab combined with paclitaxel(albumin binding type)in the treatment of metastatic or recurrent triple-negative breast cancer(TNBC).METHODS Based on the data of TORCHLIGHT clinical trial,a three-state partitioned survival model including progression-free survival,disease progression,and death was established.The simulation cycle was 21 days,the study duration was 10 years,and the discount rate was 5%.Using quality-adjusted life year(QALY)and cost as output indicators,a cost-effectiveness analysis method was adopted to calculate the incremental cost-effectiveness ratio(ICER)of toripalimab combined with paclitaxel(albumin binding type)versus placebo combined with paclitaxel(albumin binding type).Using three times the per capita gross domestic product(GDP)of China in 2023 as the willingness-to-pay(WTP)threshold(268074 yuan/QALY),the cost-effectiveness of the above two regimens was evaluated,and the sensitivity analysis was conducted.RESULTS ICER of toripalimab combined with paclitaxel(albumin binding type)versus placebo combined with paclitaxel(albumin binding type)in the treatment of Chinese metastatic or recurrent TNBC patients was 176347.17 yuan/QALY,which was lower than the WTP threshold set in this study,demonstrating the cost-effectiveness of this regimen.The results of the single-factor sensitivity analysis showed that the parameters such as the cost of toripalimab,discount rate,and utility value of the progression-free survival state had a great impact on the ICER.The results of the probabilistic sensitivity analysis indicated that the results of the basic analysis were robust.CONCLUSIONS When three times the per capita GDP of China in 2023 is used as the WTP threshold,compared with the regimen of placebo combined with paclitaxel(albumin binding type),toripalimab combined with paclitaxel(albumin binding type)is cost-effective in the treatment of metastatic or recurrent TNBC.

关 键 词：特瑞普利单抗 三阴性乳腺癌 成本-效果分析 药物经济学 分区生存模型 

分 类 号：R956[医药卫生—药学] R979.1