中国药房2024，Vol.35Issue(11)：1357-1362,6.DOI:10.6039/j.issn.1001-0408.2024.11.13
贝伐珠单抗联合厄洛替尼一线治疗晚期EGFR突变型非鳞状NSCLC的成本-效用分析
Cost-utility analysis of bevacizumab combined with erlotinib in the first-line treatment of advanced EGFR mutant non-squamous NSCLC
摘要
Abstract
OBJECTIVE To evaluate the cost-effectiveness of bevacizumab combined with erlotinib in the first-line treatment of advanced EGFR mutant non-squamous non-small cell lung cancer(NSCLC)from the perspective of China's health system.METHODS A dynamic Markov model was established based on BEVERLY study data,with a cycle of 3 weeks,a research deadline until 99%of patients die,and an annual discount rate of 5%.The model outputs were total cost,quality-adjusted life year(QALY),and incremental cost-effectiveness ratio(ICER).Taking 3 times China's per capita gross domestic product(GDP)in 2023 as the willingness-to-pay(WTP)threshold,the cost-utility analysis was used to evaluate the cost-effectiveness of bevacizumab combined with erlotinib(observation group)versus erlotinib alone(control group)in the first-line treatment of advanced EGFR mutant non-squamous NSCLC,and the single factor sensitivity analysis and probability sensitivity analysis were used to verify the robustness of the basic analysis results.RESULTS The results of the basic analysis showed that compared with the erlotinib therapy plan,ICER of bevacizumab combined with erlotinib was 1 452 243.01 yuan/QALY,which was more than 3 times China's per capita GDP in 2023(268 074 yuan/QALY)as the WTP threshold,indicating that bevacizumab combined with erlotinib was not cost-effective.The results of single factor sensitivity analysis showed that the cost of bevacizumab,the utility value of progression-free survival and progressed disease status had a great influence on the results.The results of probability sensitivity analysis showed that when the WTP threshold was 1 740 000 yuan/QALY,the probability of cost-effective of bevacizumab combined with erlotinib plan was 50%.CONCLUSIONS Compared with erlotinib alone,bevacizumab combined with erlotinib is not cost-effective in the first-line treatment of advanced EGFR mutant non-squamous NSCLC,when using 3 times China's per capita GDP in 2023 as the WTP threshold.关键词
贝伐珠单抗/厄洛替尼/动态Markov模型/成本-效用分析/表皮生长因子受体/非鳞状非小细胞肺癌/药物经济学评价Key words
bevacizumab/erlotinib/dynamic Markov model/cost-utility analysis/epithelial growth factor receptor/non-squamous non-small cell lung cancer/pharmacoeconomic evaluation分类
医药卫生引用本文复制引用
居文祥,赵荧荧,路萝兰,张小涵,沈爱宗..贝伐珠单抗联合厄洛替尼一线治疗晚期EGFR突变型非鳞状NSCLC的成本-效用分析[J].中国药房,2024,35(11):1357-1362,6.基金项目
安徽省高校协同创新项目(No.GXXT-2020-062) （No.GXXT-2020-062）
