中国药房2026，Vol.37Issue(16)：2138-2143,6.DOI:10.6039/j.issn.1001-0408.2026.16.10
维迪西妥单抗联合特瑞普利单抗一线治疗HER2表达局部晚期或转移性尿路上皮癌的成本-效用分析
Cost-utility analysis of disitamab vedotin plus toripalimab as first-line treatment for HER2-expressing locally advanced or metastatic urothelial carcinoma
摘要
Abstract
OBJECTIVE To evaluate the cost-utility of disitamab vedotin(DV)combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic urothelial carcinoma(UC)with human epidermal growth factor receptor 2(HER2)expression from the perspective of China's health-care system.METHODS A cost-utility analysis was performed.A three-state partitioned survival model was constructed based on the RC48-C016 trial with a 1-week cycle length.The long-term health benefits[quality-adjusted life years(QALYs)]and costs of disitamab vedotin combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic UC with HER2 expression were simulated.The simulation time horizon was set to 15 years,and the discount rate was 4.5%.The willingness-to-pay(WTP)threshold was defined as twice China's per capita gross domestic product(GDP)in 2025(199 330 yuan/QALY).The incremental cost-effectiveness ratio(ICER)between the two groups was compared,and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted.RESULTS Compared with platinum-containing chemotherapy regimen,the DV plus toripalimab regimen yielded an additional 1.01 QALYs with an incremental cost of 183 224.45 yuan,and the ICER was 181 728.15 yuan/QALY,which was below the WTP threshold.At the current threshold,the probability that the DV combination regimen had a cost-utility advantage was 79.9%.CONCLUSIONS Taking twice China's per capita GDP in 2025 as the WTP threshold,DV combined with toripalimab exhibits a cost-utility advantage over platinum-containing chemotherapy as first-line treatment for HER2-expressing locally advanced or metastatic urothelial carcinoma.关键词
维迪西妥单抗/特瑞普利单抗/尿路上皮癌/成本-效用分析/分区生存模型Key words
disitamab vedotin/toripalimab/urothelial carcinoma/cost-utility analysis/partitioned survival model分类
医药卫生引用本文复制引用
向佩妍,张慧,张凯鑫,曾桂浩,蔡毕坤,刘宇航,胡双双,刘永辉..维迪西妥单抗联合特瑞普利单抗一线治疗HER2表达局部晚期或转移性尿路上皮癌的成本-效用分析[J].中国药房,2026,37(16):2138-2143,6.基金项目
教育部人文社会科学研究规划基金项目(No.22YJAZH147) （No.22YJAZH147）
广东省普通高校特色创新类项目(No.2024WTSCX1-07) （No.2024WTSCX1-07）
广东现代医院管理研究所2025-2026年度专项研究课题(No.GDXDYGS2025061) （No.GDXDYGS2025061）
广东药科大学药物经济学与卫生技术评估研究团队项目(No.2024ZZ13) （No.2024ZZ13）
