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特瑞普利单抗联合化疗对比化疗一线治疗中国晚期食管鳞癌的经济学评价。

Economic evaluation of toripalimab plus chemotherapy compared with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma in China.

机构信息

Department of pharmacy, Cancer hospital of Shantou University Medical College, Shantou, China.

Department of pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(6):683-690. doi: 10.1080/14737167.2023.2206570. Epub 2023 Apr 24.

Abstract

OBJECTIVES

The purpose of this study was to compare the cost-effectiveness of toripalimab versus Chemotherapy for patients with advanced esophageal squamous cell carcinoma (ESCC) from the perspective of the Chinese healthcare system.

METHODS

A partitioned survival model was designed. Clinical data on survival was taken from the JUPITER-06 trials. Direct medical expenditures and utilities were gathered from published literature and a local database. One-way and probability sensitivity methods were used to evaluate the model's robustness.

RESULTS

Compared with chemotherapy alone, toripalimab offered an incremental cost of $8950.427 with an additional 0.294 QALYs, yielding an ICER of 30,443.629$/QALYs first-line therapy for advanced ESCC. The ICER was below the threshold of willingness to pay in China, indicating that the toripalimab group had a cost-effective advantage. Sensitivity analysis showed that the ICERs were most sensitive to the utility of PD, but all the parameters had no significant impact on the model's outcomes.

CONCLUSION

Toripalimab may be a cost-effective first-line treatment choice in our research when compared to chemotherapy alone for patients with advanced ESCC.

摘要

目的

本研究旨在从中国医疗体系的角度比较特瑞普利单抗与化疗治疗晚期食管鳞癌(ESCC)患者的成本效益。

方法

设计了一个分割生存模型。生存的临床数据来自 JUPITER-06 试验。直接医疗支出和效用数据来自已发表的文献和本地数据库。采用单因素和概率敏感性分析方法评估模型的稳健性。

结果

与单纯化疗相比,特瑞普利单抗增加了 8950.427 美元的增量成本,同时增加了 0.294 个 QALYs,使得晚期 ESCC 一线治疗的增量成本效益比为 30443.629 美元/QALY。增量成本效益比低于中国的意愿支付阈值,表明特瑞普利单抗组具有成本效益优势。敏感性分析表明,ICER 对 PD 效用最为敏感,但所有参数对模型结果均无显著影响。

结论

与单纯化疗相比,特瑞普利单抗可能是晚期 ESCC 患者的一种具有成本效益的一线治疗选择。

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