苏格马利单抗联合化疗治疗晚期食管鳞状细胞癌的成本效益分析
Sugemalimab combined with chemotherapy for the treatment of advanced esophageal squamous cell carcinoma: a cost-effectiveness analysis
DOI 原文链接
用sci-hub下载
如无法下载，请从 Sci-Hub 选择可用站点尝试。
影响因子:4.8
分区:医学3区 / 药学3区
发表日期:2024
作者:
Hongfu Cai, Ling Fang, Zhiwei Zheng
DOI:
10.3389/fphar.2024.1396761
摘要
本研究旨在从中国医疗体系的角度系统分析苏格马利单抗联合化疗治疗晚期食管鳞状细胞癌（ESCC）的成本效益。构建模拟模型，采用分层存活分析方法，模拟接受苏格马利单抗联合化疗与单纯化疗的患者疾病进展。数据来源包括临床试验、经济数据库，确保分析的准确性。通过计算增量性成本效益比（ICER）评估其成本效益，并进行单因素和概率敏感性分析以验证模型的稳健性。结果显示，接受苏格马利单抗治疗组的总支出为41734.87美元，安慰剂组为22926.25美元。ICER值为每QALY 61066.96美元，超过中国设定的WTP阈值（每QALY 39855.79美元）。敏感性分析表明，结果对苏格马利单抗的价格、无进展生存期和效用值较为敏感，但未改变结论。综上，苏格马利单抗联合化疗在中国用于ESCC的治疗目前尚不具成本效益，但价格进一步降低可能实现成本效益。
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.