Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China.
Front Public Health. 2024 Jul 29;12:1421826. doi: 10.3389/fpubh.2024.1421826. eCollection 2024.
This study focuses on assessing the cost-effectiveness of incorporating toripalimab alongside chemotherapy for the treatment of patients diagnosed with metastatic triple-negative breast cancer from the perspective of the Chinese healthcare system.
A partitioned survival model was constructed to simulate the costs and health outcomes over the lifetime of patients with mTNBC. Clinical data regarding overall survival, progression-free survival, and treatment-related adverse events were derived from the TORCHLIGHT clinical trials. Incremental cost-effectiveness ratio (ICER) were calculated based on the gains in quality-adjusted life-year (QALY). The willingness-to-pay (WTP) threshold was defined as $39,855.79 per QALY. Additionally, sensitivity analyses were conducted to examine the robustness of the model.
The total cost incurred by the group receiving toripalimab was $38,040.62, while the placebo plus chemotherapy was $26,102.07. The utilization of the toripalimab regimen resulted in an increase of 0.74 QALYs and an incremental cost of $11,938.55 compared to the placebo plus chemotherapy group. The ICER was $16,133.18/QALY, indicating that toripalimab plus chemotherapy is a cost-effective strategy according to the WTP threshold. Sensitivity analyses confirmed the robustness of the results.
This study suggests that the addition of toripalimab to chemotherapy for the treatment of mTNBC is a cost-effective strategy. The findings provide valuable evidence to guide decision-making regarding treatment selection for patients with mTNBC in China.
本研究旨在从中国医疗保健系统的角度评估替雷利珠单抗联合化疗治疗转移性三阴性乳腺癌（mTNBC）患者的成本效益。
构建了一个分割生存模型，以模拟 mTNBC 患者的终生成本和健康结果。总生存期、无进展生存期和治疗相关不良事件的临床数据来源于 TORCHLIGHT 临床试验。根据质量调整生命年（QALY）的获益计算增量成本效果比（ICER）。意愿支付阈值（WTP）定义为每 QALY 39,855.79 美元。此外，还进行了敏感性分析以检验模型的稳健性。
接受替雷利珠单抗治疗的患者总费用为 38,040.62 美元，而安慰剂加化疗组为 26,102.07 美元。与安慰剂加化疗组相比，替雷利珠单抗方案的使用导致 QALY 增加了 0.74 个，增量成本为 11,938.55 美元。ICER 为 16,133.18/QALY，表明替雷利珠单抗联合化疗符合 WTP 阈值的成本效益策略。敏感性分析证实了结果的稳健性。
本研究表明，替雷利珠单抗联合化疗治疗 mTNBC 是一种具有成本效益的策略。研究结果为中国 mTNBC 患者的治疗选择提供了有价值的决策依据。
