Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, PR China.
West China Biomedical Big Data Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, PR China.
Future Oncol. 2020 Jun;16(17):1189-1198. doi: 10.2217/fon-2019-0821. Epub 2020 May 14.
To investigate the cost-effectiveness of nivolumab versus chemotherapy in the second-line treatment for advanced esophageal squamous cell carcinoma. A Markov model reflecting the patients in the ATTRACTION-3 trial was established. Weibull survival model was employed to fit the Kaplan-Meier progression-free survival and overall survival probabilities of the nivolumab and chemotherapy strategy, respectively. Meanwhile, one-way and PSA were performed to test the uncertainty in the model. Overall, the incremental effectiveness and cost of nivolumab versus chemotherapy were 0.107 quality-adjusted life-years and $14,627.90, resulting in an incremental cost-effectiveness ratio of $136,709.35/quality-adjusted life-year. Nivolumab is not a cost-effective treatment option compared with chemotherapy from the perspective of Chinese society.
评估纳武利尤单抗对比化疗二线治疗晚期食管鳞癌的成本效果。建立反映ATTRACTION-3 试验患者的 Markov 模型。采用威布尔生存模型分别拟合纳武利尤单抗和化疗方案的 Kaplan-Meier 无进展生存和总生存概率。同时，进行单因素敏感性分析和 PSA 分析以检验模型的不确定性。 总体而言，纳武利尤单抗对比化疗的增量效果和增量成本分别为 0.107 个质量调整生命年和 14627.90 美元，增量成本效果比值为 136709.35 美元/质量调整生命年。从中国社会的角度来看，纳武利尤单抗对比化疗并非一种具有成本效果的治疗选择。
