目的:从我国卫生体系出发，探索维布妥昔单抗联合化疗对比单独化疗治疗CD30阳性外周T细胞淋巴瘤(peripheral T cell lymphoma，PTCL)患者的经济性。方法:以ECHELON-2试验及相关文献数据为基础，构建三状态分区生存模型，模型周期为21 d，模拟时限为10年。以质量调整生命年(quality-adjusted life years，QALYs)作为产出指标，评价两方案的经济性，并通过单因素敏感性和概率敏感性分析验证结果。结果:基础分析结果显示，维布妥昔单抗联合环磷酰胺、阿霉素、泼尼松(A+CHP)方案的成本与效用均高于环磷酰胺、阿霉素、长春新碱、泼尼松(CHOP)方案，ICER值为95 069。05元/QALY，远低于意愿支付阈值，证明具有经济性。单因素敏感性分析结果表明成本贴现率、效用贴效率、PFS效用值、维布妥昔单抗成本等对ICER影响较大。概率敏感性分析验证了基础分析结果的稳健性。结论:在3倍2023年我国人均国内生产总值(GDP，即268 047元)的支付阈值下，维布妥昔单抗联合化疗治疗CD30阳性PTCL具有经济性。
Cost-effect analysis of velbrentuximab plus chemotherapy for CD30-positive peripheral T-cell lymphoma
OBJECTIVE To explore the pharmacoeconomics of brentuximabvedotin plus chemotherapy versus chemo-therapy alone for CD30-expressing peripheral T cell lymphoma(PTCL)patients from the perspective of Chinese healthcare sys-tem.METHODS Based upon the ECHELON-2 trial and related literatures,a three-state partition survival model was con-structed with a model period of 21 days and a simulation time limit of 10 years.The economics of two protocols were evaluated with quality-adjusted life years(QALYs)as output parameters.And the results were verified by univariate sensitivity and prob-ability sensitivity analysis.RESULTS Basic analysis results revealed that cost and utility of brentuximabvedotin plus cyclophos-phamide,doxorubicin,prednisone(A+CHP)protocol were higher than those of cyclophosphamide,doxorubicin,vincristine&prednisone(CHOP)protocol.The value of incremental cost-effectiveness ratio(ICER,was 95 069.05 yuan/QALY.It was much lower than willing-to-pay threshold and its economy had been validated.Univariate sensitivity analysis indicated that cost discount rate,utility discount efficiency,utility value of progression-free survival(PFS)and brentuximabvedotin cost had a greater impact on ICER.Probabilistic sensitivity analysis verified the robustness of fundamental analysis results.CONCLUSION Under the condition of 3 folds payment threshold of Chinese per capita gross domestic product(GDP 268 047 yuan)in 2023,bren-tuximabvedotin plus chemotherapy is an economical treatment of CD30-expressing PTCL.
brentuximabvedotinpartition survival modelperipheral T cell lymphomacost-effectiveness analysis
NETL
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万方数据
