使用免疫检查点抑制剂（IO）是一种有前途的方法，可以最大限度地提高非小细胞肺癌（NSCLC）患者的临床获益。 PD-L1 表达可作为 IO 治疗结果的预测因素。然而，这种治疗的高昂费用造成了巨大的获取障碍。大量证据表明，对免疫治疗有反应的患者可以获得持续的临床获益。虽然 IO 在 NSCLC 治疗中显示出前景，但其高成本造成了准入障碍。本研究重点是在高专业医疗机构进行的前瞻性成本分析，以评估在 NSCLC 中实施阿特珠单抗风险分担协议 (RSA) 的经济影响该研究包括 30 名晚期 NSCLC 患者，制药公司为初始周期提供资金。如果患者有反应，政府计划将承担疾病进展之前的费用。人群中位无进展生存期为 4.67 个月，反应者的中位无进展生存期升至 9.4 个月。有反应组的 2 年总生存率为 64%，显着高于无反应组。没有 RSA 的总治疗成本为 881 859.36 美元（29 395.31 美元/患者），而采用 RSA 的总治疗成本为 530 467.12 美元（17 682.24 美元/患者），意味着成本降低了 40%。在响应者中，每位患者每年的平均生命成本下降了 22%。通过非参数检验评估的风险分担显示，药理成本存在统计学上的显着差异 (P < .001)。实施 RSA 可以优化资源分配，使 IO 治疗更容易获得，尤其是在低收入国家。© 作者( s) 2024 年。由牛津大学出版社出版。

Using immune checkpoint inhibitors (IO) is a promising approach to maximize clinical benefits for patients with non-small cell lung cancer (NSCLC). PD-L1 expression serves as a predictive factor for treatment outcomes with IO. However, the high cost of this treatment creates significant barriers to access. Substantial evidence demonstrates the sustained clinical benefits experienced by patients who respond to immunotherapy. While IOs show promise in NSCLC treatment, their high cost poses access barriers.This study focused on a prospective cost analysis conducted at a high-specialty health facility to assess the economic implications of implementing a risk-sharing agreement (RSA) for atezolizumab in NSCLC.The study included 30 patients with advanced NSCLC, with the pharmaceutical company funding the initial cycles. If patients responded, a government program covered costs until disease progression.A median progression-free survival of 4.67 months across populations, rising to 9.4 months for responders. The 2-year overall survival rate for the response group was 64%, significantly higher than for non-response. Without an RSA, a total treatment cost of $881 859.36 ($29 395.31/patient) was reported, compared to $530 467.12 ($17 682.24/patient) with an RSA, representing a 40% cost reduction. In responders, the average cost per year of life per patient dropped by 22%. Risk-sharing, assessed through non-parametric tests, showed a statistically significant difference in pharmacological costs (P < .001).Implementing RSAs can optimize resource allocation, making IO treatment more accessible, especially in low-income countries.© The Author(s) 2024. Published by Oxford University Press.