
浏览全部资源
扫码关注微信
1.安徽中医药大学药学院,合肥 230012
2.安徽省药品临床综合评价技术中心,合肥 230001
3.公共健康社会治理安徽省哲学社会科学重点实验室,合肥 230032
4.精准药物制剂与临床药学安徽省重点实验室,合肥 230001
5.中国科学技术大学附属第一医院/安徽省立医院药学部,合肥 230001
硕士研究生。研究方向:药物经济学。E-mail:877468984@qq.com
主任药师,硕士生导师,硕士。研究方向:药物经济学、药事管理。E-mail:1649441800@qq.com
收稿:2025-09-04,
修回:2025-12-24,
录用:2025-12-25,
纸质出版:2026-01-15
移动端阅览
朱啸威,朱同明,易佳,等.瑞齐替尼对比吉非替尼一线治疗EGFR突变阳性晚期非小细胞肺癌的成本-效用分析 [J].中国药房,2026,37(01):55-60.
ZHU Xiaowei,ZHU Tongming,YI Jia,et al.Cost-utility analysis of rezivertinib versus gefitinib as first-line treatment for EGFR mutation-positive advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2026,37(01):55-60.
朱啸威,朱同明,易佳,等.瑞齐替尼对比吉非替尼一线治疗EGFR突变阳性晚期非小细胞肺癌的成本-效用分析 [J].中国药房,2026,37(01):55-60. DOI: 10.6039/j.issn.1001-0408.2026.01.10.
ZHU Xiaowei,ZHU Tongming,YI Jia,et al.Cost-utility analysis of rezivertinib versus gefitinib as first-line treatment for EGFR mutation-positive advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2026,37(01):55-60. DOI: 10.6039/j.issn.1001-0408.2026.01.10.
目的
2
从中国卫生体系角度出发,评价瑞齐替尼对比吉非替尼一线治疗表皮生长因子受体(EGFR)突变阳性晚期非小细胞肺癌(NSCLC)的经济性。
方法
2
基于REZOR试验数据构建Markov模型,设定模型周期为3周,研究时限为5年。成本与健康产出均采用5%的年贴现率。采用成本-效用分析法,以3倍我国2024年人均国内生产总值作为意愿支付(WTP)阈值,通过增量成本-效果比(ICER)和增量净货币收益(INMB)评估瑞齐替尼方案对比吉非替尼方案的经济性差异,并采用敏感性分析和情境分析验证模型的稳健性。
结果
2
与吉非替尼方案相比,瑞齐替尼方案可节省成本225 310.47元,并额外获得0.57个质量调整生命年(QALY),由此产生的ICER为-395 562.80元/QALY,远小于本研究的WTP阈值,表明瑞齐替尼方案具有绝对经济性优势;INMB分析结果(389 041.26元)进一步验证了这一结论。单因素敏感性分析和概率敏感性分析均证实模型稳健性良好。情境分析通过将药品价格降低15%及调整无进展生存与疾病进展状态的效用值,所得结论与基础分析结果保持一致。
结论
2
与吉非替尼比较,瑞齐替尼作为
EGFR
突变阳性晚期NSCLC的一线治疗方案具有绝对经济性优势。
OBJECTIVE
2
To evaluate the cost-effectiveness of rezivertinib versus gefitinib as first-line treatment for epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system.
METHODS
2
A Markov model was constructed based on the REZOR trial data, with a cycle length of 3 weeks and a study duration of 5 years. Both costs and health outcomes were discounted at an annual rate of 5%. A cost-utility analysis was conducted using 3 times China’s 2024 per capita gross domestic product as the willingness-to-pay (WTP) threshold. The economic differences between the rezivertinib regimen versus the gefitinib regimen were evaluated using the incremental cost-effectiveness ratio (ICER) and incremental net monetary benefit (INMB). Sensitivity and scenario analyses were performed to verify the robustness of the model.
RESULTS
2
Compared to the gefitinib regimen, the rezivertinib regimen saved 225 310.47 yuan and gained an additional 0.57 quality-adjusted life years (QALYs), resulting in an ICER of -395 562.80 yuan/QALY, which was much lower than the WTP threshold of this study, indicating that rezivertinib had an absolute economic advantage. The INMB analysis (389 041.26 yuan) further validated this conclusion. One-way and probabilistic sensitivity analyses confirmed the robustness of the model. Scenario analysis, incorporating a 15% reduction in drug prices and adjustments to the utility values for progression free survival and progression disease, yielded consistent results with the base case analysis.
CONCLUSIONS
2
Compared to gefitinib, rezivertinib as a first-line treatment for
EGFR
mutation-positive advanced NSCLC has an absolute economic advantage.
BRAY F , LAVERSANNE M , SUNG H , et al . Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2024 , 74 ( 3 ): 229 - 263 .
DING H Y , XIN W X , TONG Y H , et al . Cost effectiveness of immune checkpoint inhibitors for treatment of non-small cell lung cancer:a systematic review [J ] . PLoS One , 2020 , 15 ( 9 ): e0238536 .
RECK M , RABE K F . Precision diagnosis and treatment for advanced non-small-cell lung cancer [J ] . N Engl J Med , 2017 , 377 ( 9 ): 849 - 861 .
LU S , ZHOU J Y , JIAN H , et al . Befotertinib (D-0316) versus icotinib as first-line therapy for patients with EGFR-mutated locally advanced or metastatic non-small-cell lung cancer:a multicentre,open-label,randomised phase 3 study [J ] . Lancet Respir Med , 2023 , 11 ( 10 ): 905 - 915 .
SHI Y K , GUO Y Z , LI X Y , et al . Rezivertinib versus gefitinib as first-line therapy for patients with EGFR-mutated locally advanced or metastatic non-small-cell lung cancer (REZOR):a multicentre,double-blind,randomised,phase 3 study [J ] . Lancet Respir Med , 2025 , 13 ( 4 ): 327 - 337 .
中国临床肿瘤学会指南工作委员会组织 . 中国临床肿瘤学会(CSCO)非小细胞肺癌诊疗指南2025 [M ] . 北京 : 人民卫生出版社 , 2025 : 114 - 117 .
SPARANO J A , GRAY R J , MAKOWER D F , et al . Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer [J ] . N Engl J Med , 2018 , 379 ( 2 ): 111 - 121 .
EISENHAUER E A , THERASSE P , BOGAERTS J , et al . New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1) [J ] . Eur J Cancer , 2009 , 45 ( 2 ): 228 - 247 .
ZHANG H , LI Y Y , LIU Y H , et al . Cost-effectiveness analyses of amivantamab plus lazertinib and lazertinib versus osimertinib in non-small cell lung cancer with EGFR mutations [J ] . Front Pharmacol , 2025 , 16 : 1527614 .
刘国恩 . 中国药物经济学评价指南2020 [M ] . 北京 : 中国市场出版社 , 2020 : 3 - 5 .
国家统计局 . 中华人民共和国2024年国民经济和社会发展统计公报 [EB/OL ] .( 2025-02-28 )[ 2025-07-10 ] . https://www.stats.gov.cn/sj/zxfb/202502/t20250228_1958817.html https://www.stats.gov.cn/sj/zxfb/202502/t20250228_1958817.html .
赵婧雨 , 金冠一 , 杨莉 . 达可替尼一线治疗表皮生长因子突变阳性非小细胞肺癌的成本-效用分析 [J ] . 中国药物经济学 , 2021 , 16 ( 1 ): 20 - 26 .
CAI H F , ZHANG L F , LI N , et al . Cost-effectiveness of osimertinib as first-line treatment and sequential therapy for EGFR mutation-positive non-small cell lung cancer in China [J ] . Clin Ther , 2019 , 41 ( 2 ): 280 - 290 .
SHAO T H , REN Y N , ZHAO M Y , et al . Cost-effectiveness analysis of camrelizumab plus chemotherapy as first-line treatment for advanced squamous NSCLC in China [J ] . Front Public Health , 2022 , 10 : 912921 .
ZHU J , HE W , YE M , et al . Cost-effectiveness of afatinib and erlotinib as second-line treatments for advanced squamous cell carcinoma of the lung [J ] . Future Oncol , 2018 , 14 ( 27 ): 2833 - 2840 .
XIANG H , MENG K H , WU M Y , et al . Cost-effectiveness analysis of first-line serplulimab plus chemotherapy for advanced squamous non-small-cell lung cancer in China:based on the ASTRUM-004 trial [J ] . Expert Rev Pharmacoecon Outcomes Res , 2024 , 24 ( 8 ): 1043 - 1051 .
CHENG R H , ZHOU Z , LIU Q . The cost-effectiveness of sugemalimab plus chemotherapy as first-line treatment for metastatic squamous and non-squamous NSCLC in China [J ] . Adv Ther , 2023 , 40 ( 10 ): 4298 - 4309 .
NAFEES B , LLOYD A J , DEWILDE S , et al . Health state utilities in non-small cell lung cancer:an international study [J ] . Asia Pac J Clin Oncol , 2017 , 13 ( 5 ): e195 - e203 .
梁淼 , 刘洋 , 王宪英 . 埃万妥单抗联合化疗用于EGFR突变的晚期NSCLC的成本-效果分析 [J ] . 中国药房 , 2025 , 36 ( 6 ): 715 - 720 .
洪望龙 , 夏一淼 , 苏广全 , 等 . 达可替尼对比吉非替尼一线治疗表皮生长因子受体突变晚期非小细胞肺癌的成本-效果分析 [J ] . 中国医院药学杂志 , 2023 , 43 ( 8 ): 925 - 930 .
WANG L X , LV N , GAO Y , et al . Cost-effectiveness analysis of penpulimab combined with paclitaxel and carboplatin as a first-line treatment for metastatic squamous non-small cell lung cancer in China [J ] . BMJ Open , 2025 , 15 ( 3 ): e091650 .
SHU Y M , DING Y L , LI F E , et al . Cost-effectiveness of nivolumab plus ipilimumab versus chemotherapy as first-line therapy in advanced non-small cell lung cancer [J ] . Int Immunopharmacol , 2023 , 114 : 109589 .
国家医保局 , 人力资源社会保障部 . 关于印发《国家基本医疗保险、工伤保险和生育保险药品目录(2023年)》的通知(医保发 〔2023〕30号)[EB/OL ] . ( 2023-12-13 )[ 2025-12-26 ] . https://www.nhsa.gov.cn/art/2023/12/13/art_104_11673.html https://www.nhsa.gov.cn/art/2023/12/13/art_104_11673.html .
ZHANG L F , LI N , LIU M B , et al . Cost-effectiveness analysis of dacomitinib versus gefitinib in the first-line treatment of EGFR-positive advanced or metastatic non-small cell lung cancer [J ] . Cancer Manag Res , 2021 , 13 : 4263 - 4270 .
0
浏览量
13
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621