依维莫司联合依西美坦用于晚期乳腺癌的药物经济学评价

Pharmacoeconomic evaluation of everolimus plus exemestane in the treatment of advanced breast cancer

目的:从支付方角度出发,评价依维莫司联合依西美坦用于晚期乳腺癌患者的经济性。方法:基于BOLERO-2临床试验,建立包括有效/稳定、进展、死亡3个状态的Markov模型,通过Treeage Pro 2011软件模拟激素受体阳性晚期乳腺癌患者10年内的疾病进展状况,计算增量成本效果比(incremental cost effectiveness ratio,ICER),并进行敏感性分析。结果:基础分析结果显示,依维莫司联用依西美坦组与依西美坦单用组相比,ICER值为587 442元/QALYs,高于意愿支付阈值(willingness-to-pay,WTP)161 940元。单因素敏感性分析和概率敏感性分析提示研究结果可靠。结论:与依西美坦单用相比,依维莫司联合依西美坦用于激素受体阳性晚期乳腺癌患者不具有成本效果。

Objective： To evaluate the economics of everolimus plus exemestane in the treatment of advanced breast cancer from the perspective of payers. Methods： A Markov model was established based on BOLERO-2 clinical trial,which included three health states： responsive/stable,progression and death,using Treeage Pro 2011 to simulate the disease progression of hormone receptor positive advanced breast cancer patients over a 10-year time horizon and calculate the incremental cost-effectiveness ratio（ ICER）,and sensitivity analysis were also performed. Results： In the basic analysis,the incremental cost-effectiveness ratio of everolimus plus exemestane compared with exemestane monotherapy was 587 442 yuan per QALYs,higher than willingness-to-pay（ WTP） threshold of 161 940 yuan. One-way sensitivity analysis and probabilistic sensitivity analysis indicated that the analysis results were reliable. Conclusion： Compared with exemestane monotherapy,everolimus plus exemestane might not be cost-effective in patients with hormone receptor positive advanced breast cancer.