呋喹替尼与瑞戈非尼作为转移性结直肠癌三线治疗的成本-效用分析

Cost-utility Analysis of Fruquintinib Versus Regorafenib as Third-line Treatment for Metastatic Colorectal Cancer

目的:从我国医疗卫生系统角度出发,比较呋喹替尼和瑞戈非尼三线治疗转移性结直肠癌(mCRC)的成本-效用。方法:基于两项Ⅲ期临床试验和一篇已发表的网状Meta分析,运用Markov模型模拟疾病进展状况,对两个用药方案进行药物成本效用分析。并采用单因素敏感性分析和概率敏感性分析对结果的不确定性进行评价。结果:基础分析结果显示,呋喹替尼组的总成本为121056.88元,效用值为0.60 QALYs(质量调整生命年);瑞戈非尼组的总成本为159426.06元,效用值为0.57 QALYs,增量成本效用比为负值。单因素敏感性分析显示总生存期(OS)风险比为最大影响因素。概率敏感性分析显示,呋喹替尼为优势方案的比例为100%。结论:与瑞戈非尼相比,呋喹替尼三线治疗mCRC更具成本效用优势。

Objective:To compare the cost-utility of fruquintinib versus regorafenib as the third-line treatment of metastatic colorectal cancer(mCRC)from the Chinese healthcare perspective.Methods:A Markov model was performed according to the disease development process,to compare the cost-utility of fruquintinib versus regorafenib,based on two phase 3 clinical trials and a published network meta-analysis.The robustness of the results was evaluated by univariate and probabilistic sensitivity analysis.Results:In the base case analysis,the fruquintinib arm provided 0.60 QALYs with a cost of￥121056.88,and regorafenib arm provided 0.57 QALYs with a cost of￥159426.06.The incremental cost-utility ratio(ICUR)of fruquintinib versus regorafenib were negative.The HR of OS had the most important impact on the ICUR.The probabilities of fruquintinib as the dominant option were 100%.Conclusion:Compared with regorafenib,fruquintinib is more cost-utility as the third-line treatment of mCRC.