阿替利珠单抗联合标准化疗方案治疗广泛期小细胞肺癌的成本-效用分析

目的:从卫生体系角度评价阿替利珠单抗联合标准化疗方案对比单用化疗方案一线治疗广泛期小细胞肺癌(ES-SCLC)的经济性.方法:参考一项Ⅲ期临床试验数据(IMpower133研究)及其他文献数据构建ES-SCLC患者分区生存模型,评价阿替利珠单抗联合标准化疗方案(依托泊苷+卡铂)对比单纯化疗方案(依托泊苷+卡铂)一线治疗...

Cost-utility Analysis of Atezolizumab Combined with Standard Chemotherapy Regimen in the First-line Treatment of Extensive-stage Small-cell Lung Cancer

OBJECTIVE:To evaluate the economics of atezolizumab combined with stardard chemotherapy regimens versus chemotherapy regimens alone as first-line treatment for extensive-stage small-cell lung cancer(ES-SCLC)from the healthcare system perspective.METHODS:A partitioned survival model was constructed using published phaseⅢclinical trial data(IMpower133)and literature data to evaluate the economics of atezolizumaba combined with standard chemotherapy regimens versus chemotherapy regimens alone as first-line treatment for ES-SCLC.One-way sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the stability of the results.RESULTS:The results of cost-utility analysis showed that the cost of atezolizumab combined with chemotherapy group was 489598.52 yuan,with utility of 0.70 QALYs;the cost of chemotherapy alone group was 126276.80 yuan,with utility of 0.55 QALYs;the incremental cost-utility ratio(ICUR)between the two groups was2361709.05 yuan/QALY,far exceeding the willingness-to-pay(WTP)in China(3 times of GDP per capita in 2019,212676 yuan).One-way sensitivity analysis showed that progression-free utility value of atezolizumab combined with chemotherapy had the greatest impact on the results of cost-utility analysis;probabilistic sensitivity analysis suggested that the atezolizumab combined with chemotherapy regimen was not economical within the WTP range of 0-500000 yuan/QALY.CONCLUSIONS:Atezolizumab combined with chemotherapy regimen has no cost-utility advantage versus chemotherapy alone in the first-line treatment of ES-CLC under the current economic level of China.