奈妥匹坦帕洛诺司琼胶囊治疗化疗所致恶心呕吐的成本-效果

Cost-effectiveness of Netopitam Palonosetron Capsules in the Treatment of Chemotherapy Induced Nausea and Vomiting

目的 评价奈妥匹坦帕洛诺司琼胶囊(NEPA)用于预防高致吐性化疗引起的恶心呕吐(CINV)的经济性,为相关部门提供决策依据。方法 以高致吐性CINV患者为研究对象,基于医疗卫生体系视角,以昂丹司琼(OND)联合地塞米松(DEX)为对照方案,构建Markov模型并使用成本-效果分析法比较各方案的成本、质量调整生命年(QALYs)及增量成本-效果比(ICER),从而评价NEPA的成本-效果优势,并进行敏感性分析来验证结果的稳定性。结果 NEPA联合DEX治疗方案累积成本为424.04元,累积QALYs为0.011 6;OND联合DEX治疗方案累积成本为275.04元,累积QALYs为0.009 7;NEPA联合DEX治疗方案相较对照方案ICER值为79 464.24元/QALY,QALYs增加了0.001 9,增长比例为19%。敏感性分析中各因素对研究结论无明显影响。结论 在预防高致吐性CINV中,以1倍GDP作为阈值条件下,NEPA联合DEX方案与OND联合DEX方案相比更具成本-效果优势。

Objective To evaluate the economy of nedupitant palonosetron capsules(NEPA) for the prevention of highly emetogenic chemotherapy-induced nausea and vomiting(CINV) in patients,and to provide a basis for decision making by the relevant authorities.Methods Using patients with highly emetogenic CINV as the study population and setting ondansetron(OND)combined with dexamethasone(DEX) as the comparison,a Markov model was constructed based on the health care system perspective.The cumulative cost,quality-adjusted life years(QALYs) and incremental cost-effectiveness ratio(ICER) of each treatment options were compared by means of cost-effectiveness analysis to evaluate the cost-effectiveness of NEPA,and sensitivity analysis was performed to verify the stability of the results.Results The cumulative cost of the NEPA combined with DEX regimen was 424.04 RMB and the cumulative QALYs was 0.011 6;the cumulative cost of the OND combined with DEX regimen was 275.04 RMB and the cumulative QALYs was 0.009 7;the ICER value of the NEPA combined with DEX regimen compared to the control regimen was 79 464.24 RMB/QALY and QALYs increased by 0.001 9 with a percentage increase of 19%.The factors in the sensitivity analysis had no significant effect on the study findings.Conclusion In the prevention of highly emetogenic CINV,the NEPA combined with DEX regimen has a cost-effectiveness advantage over the OND combined with DEX regimen under the condition of 1 time GDP per capita as a threshold.