中国药房2024，Vol.35Issue(16)：2002-2008,7.DOI:10.6039/j.issn.1001-0408.2024.16.11
阿贝西利、哌柏西利和瑞波西利一线治疗激素受体阳性晚期乳腺癌的成本-效用分析
Cost-utility analysis of abemaciclib,palbociclib and ribociclib as first-line treatment in hormone receptor-positive advanced breast cancer
摘要
Abstract
OBJECTIVE To analyze the cost-effectiveness of abemaciclib,palbociclib and ribociclib combined with aromatase inhibitors(AI)in first-line treatment of hormone receptor-positive(HR+)advanced breast cancer from the perspective of Chinese medical system.METHODS The 20-year disease course of the patients was simulated by the partitioned survival model,and the simulation period was determined to be 4 weeks,the model output was the total cost and quality-adjusted life year(QALY),the cost and effect were discounted at a discount rate of 5%.A network meta-analysis was constructed by systematically searching relevant clinical trials to obtain the efficacy parameters of abemaciclib,palbociclib and ribociclib combined with AI.Survival fitting and extrapolation were performed based on the survival curve of the placebo group in MONALEESA-2 trial.Cost-effectiveness was assessed by incremental cost-effectiveness ratio(ICER)and incremental net monetary benefit(INMB),with a willingness-to-pay threshold of 3 times China's per capita gross domestic product(GDP)in 2023;one-way sensitivity analysis and probability sensitivity analysis were used to detect the influence of parameters on the results and the robustness of the incremental analysis results.RESULTS In the 20-year simulation,compared with palbociclib+AI scheme,the ICER of ribociclib+AI scheme was 58 558.38 yuan/QALY and the INMB was 62 988.20 yuan.Compared with ribociclib+AI scheme,the ICER of abemaciclib+AI scheme was 264 928.34 yuan/QALY and the INMB was 344.84 yuan.One-way sensitivity analysis showed that the incremental analysis results of abemaciclib+AI scheme compared to ribociclib+AI scheme were not robust.Probabilistic sensitivity analysis confirmed that the probability of ribociclib+AI scheme becoming the most economical was the highest when the threshold was 1-3 times China's per capita GDP in 2023.CONCLUSIONS Ribociclib+AI scheme is more likely to be the most economical first-line treatment than abemaciclib+AI scheme and palbociclib+AI scheme in Chinese patients with HR+advanced breast cancer when threshold is 1-3 times China's per capita GDP in 2023.关键词
晚期乳腺癌/激素受体阳性/阿贝西利/哌柏西利/瑞波西利/分区生存模型/成本-效用分析/增量净货币收益Key words
advanced breast cancer/hormone receptor-positive/abemaciclib/palbociclib/ribociclib/partitioned survival model/cost-utility analysis/incremental net monetary benefit分类
医药卫生引用本文复制引用
李梦媛,管欣,嵇欣悦,王雨菲,田磊..阿贝西利、哌柏西利和瑞波西利一线治疗激素受体阳性晚期乳腺癌的成本-效用分析[J].中国药房,2024,35(16):2002-2008,7.基金项目
山东省医疗保障局购买服务项目(No.7422100030) （No.7422100030）
