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引用本文:张森,贾才凤,徐浩,李赛男,康朔.优替德隆联合卡培他滨二线治疗转移性乳腺癌的药物经济学评价[J].中国现代应用药学,2023,40(19):2732-2737.
ZHANG Sen,JIA Caifeng,XU Hao,LI Sainan,KANG Shuo.Pharmacoeconomics Evaluation of Utidelone Combined with Capecitabine in the Second-line Treatment of Metastatic Breast Cancer[J].Chin J Mod Appl Pharm(中国现代应用药学),2023,40(19):2732-2737.
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优替德隆联合卡培他滨二线治疗转移性乳腺癌的药物经济学评价
张森1, 贾才凤2, 徐浩3, 李赛男4, 康朔5
1.河北医科大学第四医院, 药学部, 石家庄 050011;2.河北医科大学第四医院, 临床药理研究部, 石家庄 050011;3.河北医科大学第四医院, 医保办, 石家庄 050011;4.河北医科大学第四医院, 乳腺中心, 石家庄 050011;5.河北医科大学第二医院医保办, 石家庄 050011
摘要:
目的 从中国卫生体系角度评价优替德隆联合卡培他滨与单用卡培他滨相比二线治疗转移性乳腺癌的经济性。方法 利用临床试验数据和相关文献数据建立分区生存模型,模型的循环周期设为3周,模拟时限为15年,成本和效用数据均采用5%的贴现率进行贴现处理,模型产出指标为增量成本-效果比(incremental cost-effectiveness ratio,ICER),意愿支付阈值(willingness-to-pay,WTP)设为2021年中国1~3倍人均国内生产总值(gross domestic product,GDP)(80 976元/QALY~ 242 928元/QALY)。进行单因素敏感性分析和概率敏感性分析以评价模型参数变化时模型结果的稳定性。结果 基础分析结果显示,优替德隆联合卡培他滨属于高成本高健康获益方案,2个方案相比的ICER值为393 949.83元/QALY。单因素敏感性分析表明优替德隆的价格是对ICER值影响最大的因素,概率敏感性分析表明模型结果具有稳健性。结论 优替德隆联合卡培他滨与单用卡培他滨相比二线治疗转移性乳腺癌不具有经济学优势,但在人均GDP超过131 316元的地区,优替德隆联合卡培他滨成为具有成本-效果优势的方案。
关键词:  优替德隆  卡培他滨  转移性乳腺癌  药物经济学
DOI:10.13748/j.cnki.issn1007-7693.20224209
分类号:R956
基金项目:
Pharmacoeconomics Evaluation of Utidelone Combined with Capecitabine in the Second-line Treatment of Metastatic Breast Cancer
ZHANG Sen1, JIA Caifeng2, XU Hao3, LI Sainan4, KANG Shuo5
1.The Fourth Hospital of Hebei Medical University, Department of Pharmacy, Shijiazhuang 050011, China;2.The Fourth Hospital of Hebei Medical University, Department of Clinical Pharmacology, Shijiazhuang 050011, China;3.The Fourth Hospital of Hebei Medical University, Department of Medical Insurance, Shijiazhuang 050011, China;4.The Fourth Hospital of Hebei Medical University, Department of Breast Center, Shijiazhuang 050011, China;5.Department of Medical Insurance, The Second Hospital of Hebei Medical University, Shijiazhuang 050011, China
Abstract:
OBJECTIVE To evaluate the economics of utidelone combined with capecitabine compared with capecitabine in the second-line treatment of metastatic breast cancer from the perspective of Chinese health-care system. METHODS A partitioned survival model was established using clinical trial data and relevant literature data, with the cycle of 3 weeks and the time horizon of 15 years. Cost and utility data were discounted using a discount rate of 5%. The model output was the incremental cost-effectiveness ratio(ICER), and the willingness-to-pay threshold(WTP) was set to 1-3 times per capita gross domestic product(GDP) in China in 2021(80 976 yuan/QALY-242 928 yuan/QALY). One-way sensitivity analyses and probabilistic sensitivity analyses were performed to evaluate the stability of model results when the model parameters were changed. RESULTS The results of base-case analysis showed that utidelone combined with capecitabine was a high-cost and high-health benefit regimen, and the ICER was 393 949.83 yuan/QALY. One-way sensitivity analyses showed that the price of utidelone was the most influential factor of the ICER, and the probabilistic sensitivity analyses showed that the model results were robustness. CONCLUSION Utidelone combined with capecitabine has no economic advantage compared with capecitabine alone in the second-line treatment of metastatic breast cancer, but in areas with per capita GDP of more than 131 316 yuan, utidelone combined with capecitabine can be considered the cost-effective regimen.
Key words:  utidelone  capecitabine  metastatic breast cancer  pharmacoeconomics
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