斯鲁利单抗联合化疗一线治疗晚期鳞状非小细胞肺癌的成本-效果分析  

Cost-effectiveness Analysis of Serplulimab Combined with Chemotherapy for the First-line Treatment of Advanced Squamous Non-small Cell Lung Cancer

作　　者：徐蕾[1] 王皓[2] 葛卫红[1] XU Lei;WANG Hao;GE Weihong(Department of Pharmacy,Gulou Clinical Medical College,Nanjing University of Traditional Chinese Medicine,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京中医药大学鼓楼临床医学院药学部,南京210008 [2]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《医药导报》2025年第4期662-668,共7页Herald of Medicine

基　　金：江苏省药品临床综合评价项目(苏卫办药政〔2022〕15号-4)。

摘　　要：目的从中国卫生服务体系角度,对斯鲁利单抗联合化疗一线治疗晚期鳞状非小细胞肺癌的经济性进行评估。方法构建三状态分区生存模型,使用成本效果法评价斯鲁利单抗联合化疗一线治疗晚期鳞状非小细胞肺癌的经济性。临床数据来自ASTRUM-004试验,以质量调整生命年(QALYs)为产出指标计算增量成本效果比(ICER),通过敏感性分析验证模型的稳定性,对斯鲁利单抗价格降低进行情境分析。结果基础分析结果显示,斯鲁利单抗联合化疗组相较于安慰剂联合化疗组成本增加1951442元,ICER为每生命年2498816.54元。单因素敏感性分析显示,无进展生存期(PFS)状态效用值、体质量、斯鲁利单抗价格对ICER影响较大;概率敏感性分析显示,基础分析结果稳健。情境分析结果显示,斯鲁利单抗降价20%和80%时,均不具有经济性。结论从中国卫生服务体系角度看,目前斯鲁利单抗联合化疗在一线治疗晚期鳞状非小细胞肺癌中与安慰剂联合化疗相比并不具有经济性。Objective From the perspective of China’s health service system,to evaluate the economy of the first-line treatment of advanced squamous non-small cell lung cancer with serplulimab combined with chemotherapy.Methods A three-state partitioned survival model was constructed,and the cost-effectiveness method was used to evaluate the economy of serplulimab combined chemotherapy in the first-line treatment of advanced squamous non-small cell lung cancer.The clinical data were collected from the ASTRUM-004 trial.The quality adjusted life years(QALYs)were used as the output index and the incremental cost-effectiveness ratio(ICER)was calculated.The stability of the model was verified by sensitivity analysis,and the situation analysis was carried out for the decrease of the price of serplulimab.Results The results of basic analysis showed that the cost of the combination group increased by 1951442 yuan compared with the placebo combination chemotherapy group,and the ICER was 2498816.54 yuan/QALY.Single factor sensitivity analysis showed that PFS state utility value,body weight,and serplulimab price had a greater impact on ICER.Probabilistic sensitivity analysis showed that the basic analysis results are robust.The results of the scenario analysis showed that when the price of serplulimab was reduced by 20%and 80%,it was not economical.Conclusions From the perspective of the China's health service system,currently,the combination therapy of serplulimab with chemotherapy is not cost-effective in the first-line treatment of advanced squamous cell lung cancer compared to placebo combination therapy.

关 键 词：斯鲁利单抗 鳞状非小细胞肺癌 分区生存模型 成本-效果分析 

分 类 号：R979[医药卫生—药品]