卡瑞利珠单抗对比化疗方案二线治疗晚期或转移性食管鳞状细胞癌的成本效用分析

Cost-Utility Analysis of Camrelizumab Versus Chemotherapy Regimens for Second-Line Treatment of Advanced or Metastatic Esophageal Squamous Cell Carcinoma

目的:从我国卫生服务体系的角度出发,评价卡瑞利珠单抗与化疗方案二线治疗晚期或转移性食管鳞状细胞癌的成本效用。方法:构建分区生存模型,模拟患者终身的质量调整生命年和增量成本效用比,并进行单因素敏感性分析和概率敏感性分析来检验模型的不确定性。结果:基础分析结果显示,卡瑞利珠单抗组患者比化疗组患者多获得0.58个QALYs的同时,多花费35125.33元,增量成本效用比值为61004.80元/QALY,小于3倍人均GDP;单因素敏感性分析显示对模型最敏感的3个因素分别是卡瑞利珠单抗、伊立替康的成本及PFS的效用值;概率敏感性分析显示,当意愿支付值大于100000元,卡瑞利珠单抗对比化疗方案为更具成本效用的概率为100%。结论:从我国卫生服务体系的角度来看,卡瑞利珠单抗对比化疗方案二线治疗晚期或转移性食管鳞状细胞癌更有经济性。

Objective:To evaluate the cost utility of Camrelizumab versus chemotherapy regimens for second-line treatment of advanced or metastatic esophageal squamous cell carcinoma from the perspective of the Chinese health delivery system.Methods:A partitioned survival model was constructed to simulate quality-adjusted life years(QALYs)and incremental cost-utility ratios(ICUR)over a patient’s lifetime,and one-way sensitivity analysis and probabilistic sensitivity analysis were performed to test the uncertainty of the model.Results:The results of the base analysis showed that patients in the Camrelizumab group gained 0.58 QALYs more than patients in the chemotherapy group while spending more than 35125.33 yuan,with an ICUR of 61004.80 yuan/QALY,which is less than3 times the GDP per capita;the ony-way sensitivity analysis showed that the three factors most sensitive to the model were the cost of Camrelizumab and irinotecan and the PFS The probabilistic sensitivity analysis showed that when the willingness-to-pay value was greater than 100000 yuan,the probability of Camrelizumab being more cost effective than the chemotherapy regimen was 100%.Conclusion:From the perspective of the Chinese health delivery system,Camrelizumab is more cost-effective than chemotherapy regimen for second-line treatment of advanced or metastatic esophageal squamous cell carcinoma.