多纳非尼与索拉非尼一线治疗不可切除或转移性肝细胞癌的经济学分析
Cost-effectiveness analysis of donafenib and sorafenib as a first-line treatment for unresectable or meta-static hepatocellular carcinoma
居文祥 1张小涵 1赵荧荧 1路萝兰 1沈爱宗2
作者信息
- 1. 安徽中医药大学药学院,安徽合肥 230012;安徽省药品临床综合评价技术中心,安徽合肥 230001
- 2. 安徽中医药大学药学院,安徽合肥 230012;安徽省药品临床综合评价技术中心,安徽合肥 230001;中国科技大学附属第一医院(安徽省立医院)药学部,安徽合肥 230001
- 折叠
摘要
目的:从中国卫生体系角度评价多纳非尼与索拉非尼一线治疗不可切除或转移性肝细胞癌(HCC)的经济性.方法:基于一项Ⅱ～Ⅲ期临床试验数据,通过R语言将数据重新拟合,并构建分区生存模型,以增量成本-效果比(ICER)为评价指标,比较多纳非尼与索拉非尼的经济性.对成本和效用值进行5％的贴现,使用敏感性分析验证结果的稳定性.结果:模型运行终点显示,多纳非尼相对于索拉非尼每增加一个质量调整生命年(QALYs),需要多花费91 861.42元,低于中国2022年3倍人均GDP.敏感性分析结果显示,索拉非尼与多纳非尼成本对结果影响较大;当意愿支付值(WTP)为中国2022年3倍人均GDP时,多纳非尼具有经济性的概率为89.7％.结论:多纳非尼相对于索拉非尼一线治疗不可切除或转移性HCC具有经济性.
Abstract
OBJECTIVE To evaluate the cost-effectiveness of first-line treatment of unresectable or metastatic hepatocellu-lar carcinoma(HCC)with donafenib versus sorafenib from the perspective of China health system.METHODS Based upon a phase Ⅱ-Ⅲ clinical trial,raw data were refitted by R language and a partitioned survival model was constructed for comparing the economics of donafenib versus sorafenib using incremental cost-effectiveness ratio(ICER)as an evaluation metric.After dis-counting cost and utility values by 5％,sensitivity analysis was performed for verifying the stability of the results.RESULTS At the end of modeling,each additional quality-adjusting life years(QALYs)of donafenib versus sorafenib cost 91 861.42 yuan.It was lower than per capita gross domestic product(GDP)of China in 2022 by three folds.The results of sensitivity analysis indi-cated that cost of sorafenib versus donafenib had great impact on the results.When willing-to-pay(WTP)tripled per capita GDP of China in 2022,the economical probability of donafenib was 89.7％.CONCLUSION Donafenib is more economical than sorafenib as a first-line treatment for unresectable or metastatic HCC.
关键词
多纳非尼/索拉非尼/分区生存模型/成本-效果分析Key words
donafenib/sorafenib/zoning survival model/cost-effectiveness analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据