替吉奥治疗不可切除转移性结直肠癌的药物经济学评价  

Pharmacoeconomic Evaluation of Tegafur Gimeracil and Oteracil Porassium in the Treatment of Unresectable Metastatic Colorectal Cancer

作　　者：梁欣[1] 宁霄[2] 丁樱 张梦琦 肖妍 耿晓坤[1] Liang Xin;Ning Xiao;Ding Ying;Zhang Mengqi;Xiao Yan;Geng Xiaokun(Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China;National Institutes for Food and Drug Control,Beijing 102629,China)

机构地区：[1]首都医科大学附属北京潞河医院,北京101100 [2]中国食品药品检定研究院,北京102629

出　　处：《中国药事》2025年第4期471-478,共8页Chinese Pharmaceutical Affairs

基　　金：国家重点研发计划(编号2021YFC2401100)。

摘　　要：目的:从中国卫生体系角度出发,评价替吉奥、伊立替康联合贝伐珠单抗治疗不可切除转移性结直肠癌(mCRC)的经济性,以期为临床治疗方案的选择提供参考。方法:基于TRICOLORE试验数据,建立分区生存模型比较替吉奥、伊立替康联合贝伐珠单抗(试验组)与mFOLFOX6/CapeOX联合贝伐珠单抗(对照组)治疗不可切除mCRC的经济性,以质量调整生命年(QALYs)作为产出指标计算增量成本-效用比(ICER),并通过敏感性分析验证结果。结果:基础分析结果表明,试验组比对照组患者多获得0.14个QALYs的同时多花费40700.68元,ICER值为302155.40元/QALY,大于意愿支付阈值。敏感性分析结果显示,贝伐珠单抗成本、成本贴现率、效用贴现率对经济性影响较大。结论:在以3倍2023年我国人均国内生产总值(GDP,即268272元)的支付阈值下,替吉奥、伊立替康联合贝伐珠单抗治疗不可切除mCRC不具有经济性。Objective:To evaluate the economic efficiency of tegafur gimeracil and oteracil porassium andirinotecan plus bevacizumab in the treatment of unresectable metastatic colorectal cancer(mCRC) from theperspective of Chinese health system,and to provide references for the selection of clinical treatment regimens.Methods:Based on the TRICOLORE trial data,a partitioned survival model was established to compare theeconomic efficiency of tegafur gimeracil and oteracil porassium,irinotecan plus bevacizumab(experimentalgroup) and mFOLFOX6/CapeOX plus bevacizumab(control group) in the treatment of unresectable mCRC,and the incremental cost-effectiveness ratio(ICER) was calculated by using quality-adjusted life years(QALYs)as output indicators,and the results were verified by sensitivity analysis.Results:The results of basic analysisshowed that the experimental group obtained 0.14 more QALYs than the control group and spent 40700.68RMB more,and the ICER value was 302155.40 RMB/QALY,which was higher than the willingness to paythreshold.The results of sensitivity analysis showed that the cost,cost discount rate and utility discount rateof bevacizumab had a great impact on the economic efficiency.Conclusion:Under the payment thresholdof 3 times China's per capita gross domestic product(GDP,that is,268272 RMB) in 2023,the treatmentof unresectable mCRC with tegafur gimeracil and oteracil porassium,irinotecan plus bevacizumab is noteconomical.

关 键 词：替吉奥胶囊 转移性结直肠癌 分区生存模型 成本-效用分析 

分 类 号：R95[医药卫生—药学]