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1.河北医科大学药学院,石家庄 050017
2.河北医科大学第四医院药学部,石家庄 050011
3.河北省儿童医院药学部,石家庄 050031
主管药师,硕士研究生。研究方向:抗肿瘤药物的临床综合评价。E-mail:15131469770@163.com
副主任药师,硕士生导师。研究方向:抗肿瘤药物的临床综合评价、儿童精准用药。E-mail:dongl_100@163.com
收稿:2024-12-06,
修回:2025-05-12,
录用:2025-05-13,
纸质出版:2025-06-15
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胡冬雪,郑颖,高倩,等.派安普利单抗一线治疗晚期鳞状非小细胞肺癌的药物经济学评价 [J].中国药房,2025,36(11):1364-1369.
HU Dongxue,ZHENG Ying,GAO Qian,et al.Pharmacoeconomic evaluation of penpulimab in first-line treatment of advanced squamous non-small-cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(11):1364-1369.
胡冬雪,郑颖,高倩,等.派安普利单抗一线治疗晚期鳞状非小细胞肺癌的药物经济学评价 [J].中国药房,2025,36(11):1364-1369. DOI: 10.6039/j.issn.1001-0408.2025.11.13.
HU Dongxue,ZHENG Ying,GAO Qian,et al.Pharmacoeconomic evaluation of penpulimab in first-line treatment of advanced squamous non-small-cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(11):1364-1369. DOI: 10.6039/j.issn.1001-0408.2025.11.13.
目的
2
评价派安普利单抗联合化疗方案一线治疗晚期鳞状非小细胞肺癌(以下简称“肺鳞癌”)的经济性。
方法
2
从我国卫生体系角度出发,运用成本-效用分析法评估派安普利单抗联合化疗(紫杉醇+卡铂)方案相较于标准化疗(紫杉醇+卡铂)方案一线治疗晚期肺鳞癌的经济性。使用R语言构建一个三健康状态Markov模型,模型中所需的临床数据提取自AK105-302研究,成本和效用来自开放数据库和已发表的文献。效用指标为质量调整生命年(QALY),意愿支付(WTP)阈值为2024年我国人均国内生产总值(GDP)的3倍,即287 247元/QALY。通过比较两种方案的增量成本-效果比(ICER)与WTP阈值的大小评估方案的经济性;使用单因素敏感性分析和概率敏感性分析验证基础分析的稳健性。
结果
2
派安普利单抗联合化疗方案较标准化疗方案增加了0.73 QALY,但同时成本增加150 681.93元,ICER为206 413.60元/QALY。单因素敏感性分析显示,无进展生存(PFS)状态的效用值对ICER的影响最大。概率敏感性分析显示,WTP阈值为3倍的2024年我国人均GDP时,派安普利单抗联合化疗方案具有经济性的概率为98.80%;但当WTP阈值降低为1倍我国人均GDP时,派安普利单抗联合化疗方案具有经济性的概率<0.01%。
结论
2
对于晚期肺鳞癌,当WTP阈值为3倍的2024年我国人均GDP时,派安普利单抗联合化疗是一种具有经济性的一线治疗方案。
OBJECTIVE
2
To estimate the cost-effectiveness of penpulimab combined with chemotherapy versus chemotherapy alone in first-line treatment of advanced squamous non-small-cell lung cancer (sq-NSCLC).
METHODS
2
From the perspective of Chinese health system, cost-utility analysis was used to evaluate the cost-effectiveness of penpulimab combined with chemotherapy(paclitaxel + carboplatin) versus chemotherapy (paclitaxel + carboplatin) in first-line treatment of sq-NSCLC. A three-health states Markov model was constructed with R packages, and clinical data used in the model were derived from the AK105-302 clinical trial. Costs and utilities were collected from the open-access database and published literature. The quality-adjusted life-years (QALY) was used as the utility index, and the willingness-to-pay (WTP) threshold was set at three times China’s per capita GDP in 2024, equivalent to 287 247 yuan/QALY. The cost-effectiveness of the schemes was evaluated by comparing the incremental cost-utility ratios (ICER) of the two schemes with the WTP threshold. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were used to verify the stability of the basic analysis results.
RESULTS
2
Compared with chemotherapy, penpulimab combined with chemotherapy increased 0.73 QALY with an incremental cost of 150 681.93 yuan, and the ICER was 206 413.60 yuan/QALY. One-way sensitivity analysis showed that the utility of progression-free survival was the most sensitive factor on ICERs. At the WTP threshold of 3 times China’s per capita GDP, the economic probability of this scheme was 98.80%. At the WTP threshold of 1 times China’s per capita GDP, the probability of ICER being cost-effective was less than 0.01%.
CONCLUSIONS
2
For patients with advanced sq-NSCLC, penpulimab combined with chemotherapy is a cost-effective first-line treatment option when WTP threshold is 3 times China’s per capita GDP.
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