Pharmacoeconomic evaluation of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small-cell lung cancer

QI Ran; NIE Xuyang; LIU Xuting; GAO Shengnan; LIU Guoqiang

doi:10.6039/j.issn.1001-0408.2023.11.16

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Pharmacoeconomic evaluation of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small-cell lung cancer

更新时间：2023-06-09

- Pharmacoeconomic evaluation of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small-cell lung cancer
- ZHONGGUO YAOFANG Vol. 34, Issue 11, Pages: 1368-1373(2023)
- 作者机构：
  
  1.河北医科大学第三医院临床药学部，石家庄　050051
  2.河北医科大学第四医院临床药理研究部，石家庄　050011
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.11.16
  CLC： R956;R979.1
- Published：15 June 2023，
  
  Received：08 November 2022，
  
  Revised：14 May 2023，
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齐冉,聂旭阳,刘旭婷等.斯鲁利单抗联合化疗方案一线治疗广泛期小细胞肺癌的药物经济学评价 ^Δ[J].中国药房,2023,34(11):1368-1373.

QI Ran,NIE Xuyang,LIU Xuting,et al.Pharmacoeconomic evaluation of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small-cell lung cancer[J].ZHONGGUO YAOFANG,2023,34(11):1368-1373.
齐冉,聂旭阳,刘旭婷等.斯鲁利单抗联合化疗方案一线治疗广泛期小细胞肺癌的药物经济学评价 ^Δ[J].中国药房,2023,34(11):1368-1373. DOI： 10.6039/j.issn.1001-0408.2023.11.16.

QI Ran,NIE Xuyang,LIU Xuting,et al.Pharmacoeconomic evaluation of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small-cell lung cancer[J].ZHONGGUO YAOFANG,2023,34(11):1368-1373. DOI： 10.6039/j.issn.1001-0408.2023.11.16.

摘要

目的

从我国卫生体系角度出发评价斯鲁利单抗联合化疗方案一线治疗广泛期小细胞肺癌（ES-SCLC）的经济性。

方法

基于ASTRUM-005研究和相关文献数据构建分区生存模型，模型模拟时限为10年，循环周期为3周，成本和效用值均采用5%的贴现率进行贴现。以质量调整生命年（QALY）作为模型产出指标并计算增量成本-效果比（ICER），评价斯鲁利单抗联合化疗方案（斯鲁利单抗组）对比单纯化疗方案（单纯化疗组）一线治疗ES-SCLC的经济性。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，并针对斯鲁利单抗援助计划进行情境分析。

结果

基础分析结果显示，斯鲁利单抗组相对于单纯化疗组的ICER为758 690.27元/QALY，高于以3倍2022年我国人均国内生产总值（GDP）作为的意愿支付（WTP）阈值。情境分析结果显示，斯鲁利单抗组相对于单纯化疗组的ICER为172 275.74元/QALY，低于上述WTP阈值。单因素敏感性分析结果显示，无进展生存状态效用值、斯鲁利单抗价格等对模型结果影响较大。概率敏感性分析结果显示，不考虑斯鲁利单抗援助计划时，斯鲁利单抗组具有经济性的概率为0；但考虑援助计划时，斯鲁利单抗组具有经济性的概率为100%。

结论

在以3倍2022年我国人均GDP为WTP阈值时，斯鲁利单抗组相对于单纯化疗组不具有经济性；但若将援助计划考虑在内，该结果将发生翻转。

Abstract

OBJECTIVE

To evaluate the economics of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small cell lung cancer （ES-SCLC） from the perspective of health system in China.

METHODS

A partitioned survival model was constructed based on the ASTRUM-005 clinical trial and related literature data， with a model simulation time frame of 10 years and a 3-week cycle， and both cost and utility values were discounted using a 5% discount rate. The quality-adjusted life year （QALY） was used as a model output indicator and the incremental cost-effectiveness ratio （ICER） was calculated to evaluate the economics of serplulimab combined with chemotherapy regimens （serplulimab group） versus chemotherapy alone regimens （chemotherapy alone group） for the first-line treatment of ES-SCLC. One-way sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the results of the base-case analysis and to conduct a scenario analysis for the serplulimab patient assistance program.

RESULTS

The results of the base-case analysis showed that compared with chemotherapy alone group， ICER of serplulimab group was 758 690.27 yuan/QALY， which was higher than 3 times China’s per capita gross domestic product （GDP） in 2022 as the willingness-to-pay （WTP） threshold. The results of the scenario analysis showed that compared with chemotherapy alone group， the ICER of serplulimab group was 172 275.74 yuan/QALY， which was below above WTP threshold. The one-way sensitivity analysis showed that the progress-free survival utility value， serplulimab price and so on had a significant impact on the model results. The results of the probabilistic sensitivity analysis showed that the probability of the serplulimab group being economic was 0 when the serplulimab patient assistance program was not considered， but 100% when the patient assistance program was considered.

CONCLUSIONS

At a WTP threshold of 3 times China’s per capita GDP in 2022， the serplulimab group is no cost-effectiveness compared to the chemotherapy alone group； however， this result is reversed when the patient assistance program is taken into account.

关键词

斯鲁利单抗广泛期小细胞肺癌一线化疗方案分区生存模型成本-效用分析药物经济学

Keywords

extensive-stage small cell lung cancerfirst-line chemotherapypartitioned survival modelcost-utility analysispharmacoeconomics

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