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替雷利珠单抗一线治疗非鳞状非小细胞肺癌患者的经济学分析

Economics of first-line treatment with tislelizumab in patients with nonsquamous non-small cell lung cancer.

作者信息

Wang Lin, Liu Ting, Lin Xihan, Zhang Yu, Shi Luwen, You Ruxu, Liu Jinyu

机构信息

Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

International Research Center for Medical Administration, Peking University, Beijing, China.

出版信息

Immunotherapy. 2024;16(20-22):1217-1226. doi: 10.1080/1750743X.2024.2433408. Epub 2024 Nov 28.

Abstract

OBJECTIVE

This study evaluates the cost-effectiveness of tislelizumab plus chemotherapy as a first-line treatment for locally advanced or metastatic (IIIB/IV) nonsquamous non-small cell lung cancer (nsq-NSCLC) in China.

METHODS

A Markov model projected health outcomes and costs over a lifetime, with health states including progression-free survival, progressive disease, terminal progressive disease (TPD) and death. Data came from a Chinese phase III trial. The primary outcome was quality-adjusted life years (QALYs), with incremental cost-effectiveness ratios (ICERs) calculated. Using sensitivity analysis to confirm the robustness of the results.

RESULTS

The base-case analysis showed that tislelizumab combined chemotherapy group had 1.06 more QALYs (3.967 QALYs VS 2.909 QALYs) than the chemotherapy-alone group at an incremental cost of U.S. dollars ($) 19594.75 ($43390.52 VS $23795.77), resulting in an ICER of $18,512.47/QALY. This ICER is below the willingness-to-pay (WTP) threshold of three times China's 2023 per capita GDP ($36,672.23/QALY), indicating tislelizumab is economically favorable.

CONCLUSION

The conclusion is that tislelizumab combination therapy is a cost-effective first-line treatment option for nsq-NSCLC patients in China.

摘要

目的

本研究评估在中国替雷利珠单抗联合化疗作为局部晚期或转移性(IIIB/IV期)非鳞状非小细胞肺癌(nsq-NSCLC)一线治疗的成本效益。

方法

采用马尔可夫模型预测一生的健康结局和成本,健康状态包括无进展生存期、疾病进展、终末期疾病进展(TPD)和死亡。数据来自一项中国III期试验。主要结局为质量调整生命年(QALY),并计算增量成本效益比(ICER)。通过敏感性分析来确认结果的稳健性。

结果

基础病例分析显示,替雷利珠单抗联合化疗组比单纯化疗组多1.06个QALY(3.967个QALY对2.909个QALY),增量成本为19594.75美元(43390.52美元对23795.77美元),ICER为18512.47美元/QALY。该ICER低于中国2023年人均GDP的三倍的支付意愿(WTP)阈值(36672.23美元/QALY),表明替雷利珠单抗在经济上是有利的。

结论

结论是替雷利珠单抗联合治疗是中国nsq-NSCLC患者具有成本效益的一线治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c52/11760221/9205fc9b9a80/IIMY_A_2433408_F0001_B.jpg

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