Sugemalimab与化学疗法结合治疗晚期食管鳞状细胞癌：成本效益分析
Sugemalimab combined with chemotherapy for the treatment of advanced esophageal squamous cell carcinoma: a cost-effectiveness analysis
影响因子:4.80000
分区:医学3区 / 药学3区
发表日期:2024
作者:
Hongfu Cai, Ling Fang, Zhiwei Zheng
摘要
这项研究的目的是从中国医疗保健系统的角度进行系统分析组合疗法和化学疗法的组合疗法的成本效益。先进的ESCC患者模拟分配的生存方法模型是为了模仿与化学疗法的副瘤相结合的患者的疾病进展。为了确保准确性和准确性，从综合临床试验和可靠的经济数据库中收集了临床数据，治疗成本和实用性值。成本效益分析是通过评估与已建立的付费阈值有关的增量成本效益比率进行的。进行了单向和概率的敏感性分析以评估模型的鲁棒性。用Sugemalimab管理的患者组的累积支出为41734.87美元，而安慰剂组与总成本相关联，美国22926.25美元。通过评估ICER，该ICER量化了每QALY所获得的额外成本，确定了每个QALY的61066.96美元的值。必须注意的是，该ICER值超过了中国WTP的预期阈值，每个QALY为39,855.79美元。敏感性分析表明，结果对Sugemalimab，无进展生存率和实用性值的成本敏感。这些波动并没有导致研究结果逆转。当前，Sugemalimab与中国ESCC治疗的化学疗法的结合目前尚未被认为是一种具有成本效益的治疗方法。但是，建议额外的价格额外降低可能有助于实现成本效益的潜力。
Abstract
This study aims to systematically analyze the cost-effectiveness of the combination therapy comprising sugemalimab and chemotherapy in the management of advanced ESCC from the Chinese healthcare system perspective.An advanced ESCC patient simulation partitioned survival approach model was developed to mimic the disease progression of patients undergoing treatment with sugemalimab in combination with chemotherapy versus chemotherapy alone. To ensure accuracy and precision, clinical data, treatment costs, and utility values were collected from comprehensive clinical trials and reliable economic databases. The cost-effectiveness analysis was conducted by assessing the incremental cost-effectiveness ratio in relation to the established willingness-to-pay threshold. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the model.The cumulative expenditure for the group of patients administered with sugemalimab amounted to US$ 41734.87, whereas the placebo group was associated with a total cost of US$ 22926.25. By evaluating the ICER, which quantifies the additional cost incurred per QALY gained, a value of US$ 61066.96 per QALY was determined. It is imperative to note that this ICER value surpasses the predetermined threshold for WTP in China, set at US$ 39,855.79 per QALY. Sensitivity analyses demonstrated that the results were sensitive to the cost of sugemalimab, progression-free survival, and utility values. These fluctuations did not result in a reversal of the study findings.The combination of sugemalimab with chemotherapy for the treatment of ESCC in China is currently not considered a cost-effective therapeutic approach. However, it is suggested that additional reductions in price may facilitate the potential for achieving cost-effectiveness.