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奥希替尼对比安慰剂用于中国 EGFR 突变型非小细胞肺癌术后患者的成本效果分析。

Cost-effectiveness of osimertinib versus placebo in resected EGFR-mutated non-small cell lung cancer in China.

机构信息

College of Finance, Fujian Jiangxia University, Fuzhou, China.

Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.

出版信息

Cancer Med. 2022 Dec;11(23):4449-4456. doi: 10.1002/cam4.4798. Epub 2022 Jun 11.

Abstract

PURPOSE

We aim to assess whether osimertinib postoperative adjuvant therapy, compared with placebo, is cost-effective in China.

METHODS

We set up the Markov model that contains three health states over a 20-year period. Data were collected from the ADAURA trial that included transition probabilities and safety data. Through the analysis of literature and local charges, we explore both the cost and utility values. Sensitivity analyses were employed using TreeAge Pro software to access model stability.

FINDINGS

Patients in the osimertinib group had 1.46 more Quality-adjusted Life Years (8.45 QALYs vs 6.99 QALYs) than the placebo group at an incremental cost of $14098.51($39962.99 vs $25864.48). Compared with the placebo group, the treatment strategy with osimertinib postoperative adjuvant therapy had an incremental cost-effectiveness ratio of $9661.97/QALY. The probability of the osimertinib-assisted therapy strategy being cost-effective will reach 100% if the threshold of willingness to pay is above $15,000/QALY.

IMPLICATIONS

From the perspective of the Chinese Healthcare System, the treatment strategy with osimertinib postoperative adjuvant therapy is more cost-effective than the placebo strategy.

摘要

目的

我们旨在评估奥希替尼术后辅助治疗与安慰剂相比在中国是否具有成本效益。

方法

我们建立了一个马尔可夫模型,该模型在 20 年内包含三个健康状态。数据来自 ADAURA 试验,其中包括转移概率和安全数据。通过对文献和当地费用的分析,我们探讨了成本和效用值。使用 TreeAge Pro 软件进行敏感性分析,以评估模型的稳定性。

发现

与安慰剂组相比,奥希替尼组的患者在 20 年内拥有 1.46 个更高的质量调整生命年(8.45 QALYs 与 6.99 QALYs),增量成本为 14098.51 美元(39962.99 美元比 25864.48 美元)。与安慰剂组相比,奥希替尼术后辅助治疗策略的增量成本效益比为 9661.97 美元/QALY。如果支付意愿的阈值高于 15000 美元/QALY,则奥希替尼辅助治疗策略具有成本效益的概率将达到 100%。

结论

从中国医疗保健系统的角度来看,奥希替尼术后辅助治疗策略比安慰剂策略更具成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35ba/9741963/5b07ac430389/CAM4-11-4449-g004.jpg

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