Page 99 - 《中国药房》2023年3期

·药物经济学·

信迪利单抗联合化疗方案一线治疗晚期、复发或转移性食管鳞状
细胞癌的成本-效用分析
Δ

2 #
陈秋平 ，邵明义 ，张容容 ，陈晓琦（1.河南中医药大学第一临床医学院，郑州 450046；2.河南中医药大学第
2
1＊
1
一附属医院消化科，郑州 450000）
中图分类号 R956；R979.1 文献标志码 A 文章编号 1001-0408（2023）03-0345-06
DOI 10.6039/j.issn.1001-0408.2023.03.17

摘 要 目的 从我国卫生体系角度评价信迪利单抗联合化疗方案对比单用化疗方案一线治疗晚期、复发或转移性食管鳞状细胞
癌（ESCC）的经济性，为临床合理用药提供参考。方法 基于ORIENT-15研究数据，使用TreeAge Pro 2011软件建立具有无进展生
存（PFS）、疾病进展和死亡三状态的Markov模型进行成本-效用分析，模型周期为3周，研究时限为10年，贴现率为5%。模型输出
主要结果为总成本、质量调整生命年（QALY）和增量成本-效果比（ICER）。以1～3倍2021年我国人均国内生产总值（GDP）为意
愿支付（WTP）阈值。参数的不确定性采用单因素敏感性分析和概率敏感性分析，并探讨上述2种方案在不同的贴现率、对比其他
同类治疗方案和有慈善赠药方案3种情境下的经济性。结果 基础分析结果显示，与单用化疗方案相比，信迪利单抗联合化疗方
案的ICER为64 208.75元/QALY，小于WTP阈值。单因素敏感性分析结果显示，PFS状态效用值、信迪利单抗周期成本和贴现率
对结果的影响相对较大。概率敏感性分析结果显示，当WTP阈值≥120 000元时，信迪利单抗联合化疗方案具有经济性的概率为
100%。情境分析结果显示，3种情境下的信迪利单抗联合化疗方案均较单用化疗方案更具有经济性。结论 信迪利单抗联合化疗
方案相较于单用化疗方案一线治疗晚期、复发或转移性ESCC更具有经济性。
关键词 信迪利单抗；食管鳞状细胞癌；紫杉醇；顺铂；成本-效用分析；药物经济学

Cost-utility analysis of sintilimab combined with chemotherapy in first-line treatment of advanced，
recurrent or metastatic esophageal squamous cell carcinoma
2
1
2
CHEN Qiuping ，SHAO Mingyi ，ZHANG Rongrong ，CHEN Xiaoqi（1. First College of Clinical Medicine，
1
Henan University of Chinese Medicine， Zhengzhou 450046， China；2. Dept. of Gastroenterology， the First
Affiliated Hospital of Henan University of Chinese Medicine， Zhengzhou 450000， China）
ABSTRACT OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with chemotherapy than single-use
chemotherapy in the first-line treatment of advanced， recurrent or metastatic esophageal squamous cell carcinoma （ESCC） from the
perspective of health system of our country， and provide reference for rational use of drug in clinic. METHODS Based on
ORIENT-15 study data， TreeAge Pro 2011 software was used to establish a three-state Markov model of non-progressive survival
（PFS）， disease progression and death for cost-utility analysis. The model period was 3 weeks， the research time limit was 10
years， and the discount rate was 5%. The main outputs of the model were total cost， quality-adjusted life year （QALY） and
incremental cost-effectiveness ratio （ICER）. The 1-3 times of China’s GDP per capita in 2021 was taken as the threshold of willing-
ness to pay （WTP）. The uncertainty of the parameters was analyzed by single factor sensitivity analysis and probability sensitivity
analysis， and the cost-effectiveness of the two schemes was discussed under three situations： different discount rates， comparison
with other similar treatment schemes and charitable drug donation schemes. RESULTS The results of basic analysis showed that
compared with chemotherapy plan alone， the ICER of sintilimab combined with chemotherapy was 64 208.75 yuan/QALY， which was
less than WTP threshold. The results of single factor sensitivity analysis show that PFS state utility value， cycle cost of sintilimab
and discount rate had relatively great influence on the results. Probability sensitivity analysis showed that when WTP≥120 000
yuan， the economic probability of sintilimab combined with chemotherapy plan was 100%. The results of situational analysis
showed that sintilimab combined chemotherapy was more cost-
Δ 基金项目 国家自然科学基金面上项目（No.82174529）
effective than single-use chemotherapy. CONCLUSIONS
＊第一作者 硕士研究生。研究方向：中西医结合防治消化疾病。
E-mail：2065586237@qq.com Sintilimab combined with chemotherapy is more cost-effective
# 通信作者 主任医师，博士生导师，博士。研究方向：中医药临床 than single-use chemotherapy in the first-line treatment of
疗效评价及消化系统疾病临床研究。E-mail：shmy1016@163.com advanced， recurrent or metastatic ESCC.

中国药房 2023年第34卷第3期 China Pharmacy 2023 Vol. 34 No. 3 · 345 ·