Cai Hongfu, Xu Baohua, Li Na, Zheng Bin, Zheng Zhiwei, Liu Maobai
Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.
College of Pharmacy, Fujian Medical University, Fuzhou, China.
Front Pharmacol. 2021 Nov 16;12:732912. doi: 10.3389/fphar.2021.732912. eCollection 2021.
This study aimed to analyze the cost effectiveness of camrelizumab in the second-line treatment of advanced or metastatic esophageal squamous cell carcinoma in China. On the basis of the ESCORT clinical trial, a partitioned survival model was constructed to simulate the patient's lifetime quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER). One-way sensitivity and probability sensitivity analyses were performed to test the stability of the model. Treatment of esophageal squamous cell carcinoma with camrelizumab added 0.36 QALYs and resulted in an incremental cost of $1,439.64 compared with chemotherapy, which had an ICER of $3,999 per QALY gained. The ICER was far lower than the threshold of willingness to pay for one time the GDP per capita in China. Sensitivity analysis revealed that the ICERs were most sensitive to the cost of drugs, but the parameters did not have a major effect on the results of the model. Camrelizumab is likely to be a cost-effective option compared with chemotherapy for patients with advanced or metastatic esophageal squamous cell carcinoma. This informs patient selection and clinical path development.
本研究旨在分析卡瑞利珠单抗在中国晚期或转移性食管鳞状细胞癌二线治疗中的成本效益。基于ESCORT临床试验,构建了一个分区生存模型,以模拟患者的终身质量调整生命年(QALY)、终身成本和增量成本效益比(ICER)。进行了单向敏感性分析和概率敏感性分析,以检验模型的稳定性。与化疗相比,卡瑞利珠单抗治疗食管鳞状细胞癌增加了0.36个QALY,增量成本为1439.64美元,ICER为每获得一个QALY 3999美元。该ICER远低于中国一次性人均国内生产总值支付意愿阈值。敏感性分析显示,ICER对药物成本最为敏感,但这些参数对模型结果没有重大影响。与化疗相比,卡瑞利珠单抗对于晚期或转移性食管鳞状细胞癌患者可能是一种具有成本效益的选择。这为患者选择和临床路径制定提供了依据。