摘要
目的 从中国卫生体系的角度,对于阿美替尼二线治疗EGFRT790M阳性的晚期非小细胞肺癌患者的经济性开展药物经济学评价,为临床用药选择提供参考.方法 采用三状态分区生存模型,采用成本效用分析,生存数据来源于APOLLO和AURA3临床试验,成本和效用等参数信息来自公开发表的文献,对EGFRT790M阳性的晚期非小细胞肺癌患者使用阿美替尼和奥希替尼进行药物经济学评价,并对结果进行敏感性分析.结果 在基础分析中,阿美替尼相比奥希替尼可改善生存获益并增加成本,ICER为218 926.80元/QALY.单因素敏感性分析表明,阿美替尼和奥希替尼的成本对ICER的影响较大.概率敏感性分析显示,阿美替尼方案随着WTP阈值的升高,具有经济性的概率增加.结论 从中国卫生体系角度来看,以3倍我国人均GDP为WTP,阿美替尼对比奥希替尼二线治疗EGFRT790M阳性的晚期NSCLC具有经济性,并随着WTP阈值的提高,经济性优势增加.
Abstract
Objective To evaluate the pharmacoeconomics of aumolertinib as a second-line regimen for EGFR T790M-positive patients with advanced non-small cell lung cancer(NSCLC)from the perspective of Chinese healthcare system,and to provide reference for clinical medication selection.Methods A three-state partitioned survival model was used in the cost-effectiveness analysis.Survival data were sourced from the APOLLO and AURA3 clinical trials,while parameter for cost and effectiveness were derived from published literatures.A pharmacoeconomic evaluation was performed for EGFR T790M-positive patients with advanced NSCLC treated with aumolertinib and osimertinib,respectively.The sensitivity of the results was analyzed.Results In the base-case analysis,aumolertinib improved survival benefits but increased the costs as compared with osimertinib,with an incremental cost-effectiveness ratio(ICER)of 218 926.80 Yuan per quality-adjusted life year(QALY).Univariate sensitivity analysis indicated that the costs of both aumolertinib and osimertinib greatly influenced the ICER.Probabilistic sensitivity analysis showed that the probability of aumolertinib being cost-effective increased as the willingness-to-pay(WTP)threshold rose.Conclusion From the perspective of the Chinese healthcare system,with a WTP threshold set at three times the per capita GDP of China,aumolertinib is economically viable as compared with osimertinib as second-line regimen for EGFR T790M-positive patients with advanced NSCLC.The economic advantage of aumolertinib over osimertinib increases with the WTP threshold.
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万方数据