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替雷利珠单抗治疗局部晚期或转移性（非）鳞状 NSCLC 的成本-

效用分析
Δ

＊
王春燕 ，吴 婧，沈丽霞（中国人民解放军海军第九七一医院药剂科，山东 青岛 266071）

中图分类号 R956；R979.1 文献标志码 A 文章编号 1001-0408（2025）11-1370-05
DOI 10.6039/j.issn.1001-0408.2025.11.14

摘 要 目的 从我国卫生体系角度出发，评价替雷利珠单抗单药治疗既往接受过含铂双药方案化疗后疾病进展或不可耐受的局
部晚期或转移性鳞状或非鳞状非小细胞肺癌（NSCLC）患者的经济性。方法 根据Rationale-303研究数据构建分区生存模型，设
定模型周期为21 d，模拟时间为120个月。以质量调整生命年（QALY）为健康产出指标，采用5%的贴现率对成本和健康产出进行
贴现，计算增量成本-效果比（ICER），并采用单因素敏感性分析和概率敏感性分析验证基础分析结果的稳健性。结果 成本-效用
分析结果显示，替雷利珠单抗组方案相对于多西他赛组方案的ICER为65 653.52元/QALY，即当意愿支付阈值（WTP）为3倍2023
年我国人均国内生产总值（268 200元/QALY）时，替雷利珠单抗组方案比多西他赛组方案更具有经济性。单因素敏感性分析结果
显示，对ICER影响程度较大的3个参数分别是替雷利珠单抗成本、多西他赛成本、培美曲塞成本。概率敏感性分析结果显示，当
WTP阈值约为65 000元/QALY时，上述两组治疗方案具有经济性的概率均为50%；当WTP阈值≥134 000元/QALY时，替雷利珠
单抗组方案具有经济性的概率为 100%。结论 从我国卫生体系角度出发，以 3 倍 2023 年我国人均国内生产总值作为 WTP 阈值
时，与多西他赛相比，替雷利珠单抗单药治疗既往接受过含铂双药方案化疗后疾病进展或不可耐受的局部晚期或转移性鳞状或非
鳞状NSCLC患者具有经济性。
关键词 替雷利珠单抗；非小细胞肺癌；分区生存模型；成本-效用分析

Cost-utility analysis of tislelizumab in the treatment of locally advanced or metastatic （non-）squamous
NSCLC
WANG Chunyan，WU Jing，SHEN Lixia（Dept. of Pharmacy， No. 971 Hospital of the Navy of the PLA，
Shandong Qingdao 266071， China）

ABSTRACT OBJECTIVE From the perspective of China’s healthcare system， to evaluate the cost-effectiveness of tislelizumab
in patients with locally advanced or metastatic squamous or non-squamous non-small cell lung cancer （NSCLC） whose disease
progresses or is intolerable after receiving platinum-containing dual chemotherapy in the past. METHODS Rationale-303 research
data were used to construct a partitioned survival model. The model period was set to be 21 days and simulated to 120 months.
Using quality-adjusted life year （QALY） as a health output index， the incremental cost-effectiveness ratio （ICER） was calculated
by discounting cost and health output with a discount rate of 5%. Single-factor sensitivity analysis and probability sensitivity
analysis were performed to verify the robustness of the basic analysis results. RESULTS Cost-utility analysis results showed that the
ICER of tislelizumab group was 65 653.52 yuan/QALY， compared with docetaxel group. This means that the regimen of
tislelizumab was more cost-effective than the docetaxel regimen when the willingness-to-pay threshold （WTP） was 3 times China’s
gross domestic product （GDP） per capita in 2023 （268 200 yuan/QALY）. The results of single-factor sensitivity analysis showed
that the three parameters that had a greater impact on ICER were the prices of tislelizumab， docetaxel and pemetrexed. The results
of the probabilistic sensitivity analysis showed that the probabilities of the above two treatment regimens being cost-effective were
both 50% when the WTP threshold was approximately 65 000 yuan/QALY. The probability of tislelizumab regimen being cost-
effective was 100% when the WTP threshold was ≥134 000 yuan/QALY. CONCLUSIONS From the perspective of China’s
healthcare system， when taking 3 times China’s GDP per capita in 2023 as the WTP threshold， tislelizumab is cost-effective for
patients with locally advanced or metastatic squamous or non-squamous NSCLC after receiving platinum-containing dual
chemotherapy in the past， compared with docetaxel.
KEYWORDS tislelizumab； non-small cell lung cancer； partitioned survival model； cost-utility analysis

在我国，肺癌的发病率和死亡率在男性和女性癌症
Δ 基金项目 青岛市医药卫生科研指导项目（No.2022-WJZD213）
患者中均排第一，且呈上升趋势 。非小细胞肺癌（non-
[1]
＊第一作者 主任药师，硕士。研究方向：临床药学、药物经济学。
电话：0532-51870213。E-mail：wangchunyan401@126.com small cell lung cancer，NSCLC）是肺癌中最为常见的病

· 1370 · China Pharmacy 2025 Vol. 36 No. 11 中国药房 2025年第36卷第11期