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苏格吉马布联合化疗治疗晚期食管鳞状细胞癌:成本效益分析

Sugemalimab combined with chemotherapy for the treatment of advanced esophageal squamous cell carcinoma: a cost-effectiveness analysis.

作者信息

Cai Hongfu, Fang Ling, Zheng Zhiwei

机构信息

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

Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, China.

出版信息

Front Pharmacol. 2024 Jun 28;15:1396761. doi: 10.3389/fphar.2024.1396761. eCollection 2024.

Abstract

BACKGROUND

This study aims to systematically analyze the cost-effectiveness of the combination therapy comprising sugemalimab and chemotherapy in the management of advanced ESCC from the Chinese healthcare system perspective.

METHODS

An advanced ESCC patient simulation partitioned survival approach model was developed to mimic the disease progression of patients undergoing treatment with sugemalimab in combination with chemotherapy chemotherapy alone. To ensure accuracy and precision, clinical data, treatment costs, and utility values were collected from comprehensive clinical trials and reliable economic databases. The cost-effectiveness analysis was conducted by assessing the incremental cost-effectiveness ratio in relation to the established willingness-to-pay threshold. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the model.

RESULTS

The cumulative expenditure for the group of patients administered with sugemalimab amounted to US$ 41734.87, whereas the placebo group was associated with a total cost of US$ 22926.25. By evaluating the ICER, which quantifies the additional cost incurred per QALY gained, a value of US$ 61066.96 per QALY was determined. It is imperative to note that this ICER value surpasses the predetermined threshold for WTP in China, set at US$ 39,855.79 per QALY. Sensitivity analyses demonstrated that the results were sensitive to the cost of sugemalimab, progression-free survival, and utility values. These fluctuations did not result in a reversal of the study findings.

CONCLUSION

The combination of sugemalimab with chemotherapy for the treatment of ESCC in China is currently not considered a cost-effective therapeutic approach. However, it is suggested that additional reductions in price may facilitate the potential for achieving cost-effectiveness.

摘要

背景

本研究旨在从中国医疗保健系统的角度,系统分析苏格吉马布联合化疗在晚期食管鳞癌治疗中的成本效益。

方法

建立了一个晚期食管鳞癌患者模拟分区生存方法模型,以模拟接受苏格吉马布联合化疗和单纯化疗患者的疾病进展。为确保准确性和精确性,从综合临床试验和可靠的经济数据库中收集临床数据、治疗成本和效用值。通过评估与既定支付意愿阈值相关的增量成本效益比进行成本效益分析。进行单因素和概率敏感性分析以评估模型的稳健性。

结果

接受苏格吉马布治疗的患者组累计支出为41734.87美元,而安慰剂组的总成本为22926.25美元。通过评估每获得一个质量调整生命年所产生的额外成本的增量成本效益比,确定每质量调整生命年的价值为61066.96美元。必须指出的是,这个增量成本效益比的值超过了中国设定的每质量调整生命年39855.79美元的预定支付意愿阈值。敏感性分析表明,结果对苏格吉马布的成本、无进展生存期和效用值敏感。这些波动并未导致研究结果的逆转。

结论

在中国,苏格吉马布联合化疗治疗食管鳞癌目前不被认为是一种具有成本效益的治疗方法。然而,建议进一步降价可能有助于实现成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2687/11239512/e7a7d22d4766/fphar-15-1396761-g001.jpg

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