信迪利单抗联合化疗一线治疗局部晚期或转移性非鳞状非小细胞肺癌的成本-效用分析  

Cost-effectiveness analysis of sintilimab combined with first-line chemotherapy in the treatment of locally advanced or metastatic non-squamous non-small cell lung cancer

作　　者：吴婧 沈丽霞 曹恩惠 张哲 王春燕 WU Jing;SHEN Lixia;CAO Enhui;ZHANG Zhe;WANG Chunyan(Department of Pharmacy,No.971 Hospital of the People's Liberation Army Navy,Shandong Qingdao 266071,China)

机构地区：[1]中国人民解放军海军第971医院药剂科,山东青岛266071

出　　处：《中国医院药学杂志》2025年第6期668-673,共6页Chinese Journal of Hospital Pharmacy

基　　金：青岛市卫生科研指导项目(编号:2022-WJZD213)。

摘　　要：目的:从我国卫生体系角度出发,评价信迪利单抗联合化疗相对单纯化疗一线治疗局部晚期或转移性非鳞状非小细胞肺癌(non-small cell lung cancer,NSCLC)的成本-效用,为临床合理用药提供参考依据。方法:根据ORIENT-11新报道的生存数据构建三状态分区生存模型,模型周期设定为21 d,模拟至120个月,以质量调整生命年(quality-adjusted life years,QALYs)为健康产出指标,计算增量成本-效果比(incremental cost-effectiveness ratio,ICER),评价信迪利单抗联合化疗(干预组)相对单纯化疗(对照组)一线治疗局部晚期或转移性NSCLC的经济性。对关键参数进行单因素敏感性分析和概率敏感性分析,验证基础分析结果的稳健性。结果:成本-效用分析结果显示,干预组相对对照组的增量效用为0.4846296 QALYs,增量成本为100170.6元,ICER为206695.2元/QALY。单因素敏感性分析结果显示,对ICER影响程度较大的参数分别是未进展状态效用值、信迪利单抗价格、多西他赛价格、培美曲塞价格和进展状态效用值。概率敏感性分析结果显示,当意愿支付阈值采用3倍我国2023年人均国内生产总值(GDP)时,干预组比对照组具有经济性的概率为94.7%。结论:与单纯化疗相比,信迪利单抗联合化疗一线治疗局部晚期或转移性非鳞状NSCLC具有经济性。OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with first-line chemotherapy in the treatment of locally advanced or metastatic non-squamous non-small cell lung cancer(NSCLC)compared with first-line chemotherapy alone from the perspective of China's health system,providing a reference for clinical rational drug use.METHODS Based on the survival data reported by ORIENT-11,a three-state partitioned survival model(PSM)was constructed.The model period was set to 21 days and simulated to 120 months.The incremental cost-effectiveness ratio(ICER)was calculated using qualityadjusted life years(QALY)as an indicator of health outcomes.The economics of sintilimab combined first-line chemotherapy(intervention group)compared with first-line chemotherapy alone(control group)in the treatment of locally advanced or metastatic NSCLC was evaluated.Single factor sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the basic analysis results.RESULTS The results of cost-effectiveness analysis showed that compared with control group,the incremental effectiveness of intervention group was 0.4846296 QALYs,the incremental cost was 100170.6 yuan,and ICER was 206695.2 yuan/QALY.The results of single factor sensitivity analysis showed that the parameters that had a greater impact on ICER were the utility value of the unadvanced state,the price of sintilimab,the price of docetaxel,the price of pemetrexed and the utility value of the advanced state.Probabilistic sensitivity analysis indicated that when the willing to pay threshold was set 3 times China's 2023 percapita gross domestic product(GDP),the probability of economic performance in the intervention group was 94.7%compared with the control group.CONCLUSION Compared with chemotherapy alone,sintilimab combined with first-line chemotherapy is cost-effective in the treatment of locally advanced or metastatic non-squamous NSCLC.

关 键 词：信迪利单抗 非小细胞肺癌 分区生存模型 成本-效用分析 

分 类 号：R956[医药卫生—药学] R979.1