| 帕博利珠单抗与铂类化疗方案在晚期非小细胞肺癌一线治疗中的药物经济学评价 |
| 投稿时间：2023-03-13 修订日期：2023-11-21 点此下载全文 |
| 引用本文：宋雨桐,夏德润,顾珩,唐少文,易洪刚,沃红梅.帕博利珠单抗与铂类化疗方案在晚期非小细胞肺癌一线治疗中的药物经济学评价[J].药学实践杂志,2024,42(8):334~340 |
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| 基金项目:江苏高校品牌专业建设工程资助项目（预防医学，苏教高[2020]9号）；南京医科大学哲学社会科学发展专项项目（2019ZSY006） |
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| 中文摘要:目的 在程序性死亡配体-1(PD-L1)肿瘤比例得分（TPS）≥ 1%的人群中，对帕博利珠单抗和铂类化疗作为晚期非小细胞肺癌（NSCLC）一线治疗方案进行成本效果分析，为其临床用药提供参考。方法 基于Pubmed数据库，检索与帕博利珠单抗相关的随机对照试验，结合某三甲医院治疗方案建立Markov模型，模拟患者20年的成本和健康效果，并使用单因素敏感性分析和概率敏感性分析检验模型的稳定性。结果 帕博利珠单抗组与化疗组的成本效果比为58 517.60元/质量调整生命月（QALM）和41 213.08元/QALM。与化疗组相比，帕博利珠单抗组的增量成本效果比（ICER）为104 485.36元/QALM。结论 当意愿支付（WTP）为30 902元/QALM时，帕博利珠单抗方案与铂类化疗方案相比不具有成本效果优势，敏感性分析显示模型的结果较为稳定。 |
| 中文关键词:帕博利珠单抗 非小细胞肺癌 一线治疗 Markov模型 成本效果分析 经济学评价 |
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| Pharmacoeconomic evaluation of pembrolizumab versus platinum chemotherapy as first-line treatment in advanced non-small cell lung cancer |
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| Abstract:Objective To make the cost-effectiveness analysis of pembrolizumab and platinum chemotherapy as the first-line treatment for advanced non-small cell lung cancer （NSCLC） in the population with tumor proportion score （TPS） ≥ 1% of PD-L1, and provide some reference for the clinical use and future price negotiation of pembrolizumab. Methods Based on Pubmed database, the published RCT literatures of pembrolizumab were analyzed, and the survival data were extracted, combined with the treatment plan of a tertiary hospital, the Markov model were established to simulate the cost and health effectiveness of patients for twenty years, and the stability of the model was tested by one-way sensitivity analysis and probability sensitivity analysis. Results Twenty years later, the cost-effectiveness ratio of pembrolizumab group and chemotherapy group was ￥58 517.60/quality adjusted life month (QALM) and ￥41 213.08/QALM. Compared with the chemotherapy group, the incremental cost effective ratio (ICER) was ￥104 485.36/QALM. Conclusion When the willingness to pay （WTP） value was ￥30 902/QALM, the pembrolizumab therapy was not more cost-effective advantages than platinum chemotherapy, and the sensitivity analysis showed that the results of the model were relatively stable. |
| keywords:pembrolizumab non-small cell lung cancer first-line therapy Markov model cost-effectiveness analysis economic evaluation |
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