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在中国间变性淋巴瘤激酶阳性且对克唑替尼耐药的晚期非小细胞肺癌患者中,伊鲁替尼对比阿来替尼的成本效益分析

The cost-effectiveness of iruplinalkib versus alectinib in anaplastic lymphoma kinase-positive crizotinib-resistant advanced non-small-cell lung cancer patients in China.

作者信息

Dai Zhanjing, Xu Jiayi, Chang Feng, Zhou Wanxin, Ren Ting, Qiu Jiaxin, Lu Yun, Lu Yuqiong

机构信息

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.

出版信息

Front Public Health. 2024 Apr 15;12:1333487. doi: 10.3389/fpubh.2024.1333487. eCollection 2024.

DOI:10.3389/fpubh.2024.1333487
PMID:38699428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11064164/
Abstract

BACKGROUND

Iruplinalkib is a second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) with efficacy in patients with ALK-positive crizotinib-resistant advanced non-small cell lung cancer (NSCLC), which is independently developed by a Chinese pharmaceutical company. This study examined the cost-effectiveness of iruplinalkib versus alectinib in the Chinese healthcare setting.

METHODS

A partitioned survival model was developed to project the economic and health outcomes. Efficacy was derived using unanchored matching-adjusted indirect comparison (MAIC). Cost and utility values were obtained from the literature and experts' opinions. Deterministic and probabilistic sensitivity analyses (PSA) were carried out to evaluate the model's robustness.

RESULTS

Treatment with iruplinalkib versus alectinib resulted in a gain of 0.843 quality-adjusted life years (QALYs) with incremental costs of $20,493.27, resulting in an incremental cost-effectiveness ratio (ICER) of $24,313.95/QALY. Parameters related to relative efficacy and drug costs were the main drivers of the model outcomes. From the PSA, iruplinalkib had a 90% probability of being cost-effective at a willingness-to-pay threshold of $37,863.56/QALY.

CONCLUSION

Compared to alectinib, iruplinalkib is a cost-effective therapy for patients with ALK-positive crizotinib-resistant advanced NSCLC.

摘要

背景

艾乐替尼是一种第二代间变性淋巴瘤激酶(ALK)酪氨酸激酶抑制剂(TKI),对ALK阳性的克唑替尼耐药的晚期非小细胞肺癌(NSCLC)患者有效,由一家中国制药公司自主研发。本研究在中国医疗环境中考察了艾乐替尼与阿来替尼的成本效益。

方法

建立了一个分段生存模型来预测经济和健康结果。疗效通过非锚定匹配调整间接比较(MAIC)得出。成本和效用值从文献和专家意见中获取。进行了确定性和概率敏感性分析(PSA)以评估模型的稳健性。

结果

与阿来替尼相比,使用艾乐替尼治疗可获得0.843个质量调整生命年(QALY),增量成本为20,493.27美元,增量成本效益比(ICER)为24,313.95美元/QALY。与相对疗效和药物成本相关的参数是模型结果的主要驱动因素。从PSA分析来看,在支付意愿阈值为37,863.56美元/QALY时,艾乐替尼具有90%的成本效益概率。

结论

与阿来替尼相比,艾乐替尼是治疗ALK阳性的克唑替尼耐药的晚期NSCLC患者的一种具有成本效益的疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/2fdd3b1376b9/fpubh-12-1333487-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/3d7aa15db484/fpubh-12-1333487-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/8d102a0a4520/fpubh-12-1333487-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/2fdd3b1376b9/fpubh-12-1333487-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/3d7aa15db484/fpubh-12-1333487-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/8d102a0a4520/fpubh-12-1333487-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0406/11064164/2fdd3b1376b9/fpubh-12-1333487-g003.jpg

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