Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer

FENG Bing; GAO Ning; GAO Shengnan; ZHANG Yuxi; ZHANG Ranran; LIU Guoqiang

doi:10.6039/j.issn.1001-0408.2025.05.13

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Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer

更新时间：2025-03-11

- Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer
- ZHONGGUO YAOFANG Vol. 36, Issue 5, Pages: 579-583(2025)
- 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.河北省药物与卫生技术综合评估学会，石家庄　050051
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.05.13
  CLC： R956
- Received：09 July 2024，
  
  Revised：15 January 2025，
  
  Accepted：2025-01-26，
  
  Published：15 March 2025
- 稿件说明：
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冯冰,高宁,高胜男等.贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌的成本-效用分析 ^Δ[J].中国药房,2025,36(05):579-583.

FENG Bing,GAO Ning,GAO Shengnan,et al.Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(05):579-583.
冯冰,高宁,高胜男等.贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌的成本-效用分析 ^Δ[J].中国药房,2025,36(05):579-583. DOI： 10.6039/j.issn.1001-0408.2025.05.13.

FENG Bing,GAO Ning,GAO Shengnan,et al.Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(05):579-583. DOI： 10.6039/j.issn.1001-0408.2025.05.13.

摘要

目的

从中国卫生体系角度出发，评估贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗广泛期小细胞肺癌（ES-SCLC）的经济性。

方法

根据ETER701研究数据构建分区生存模型，循环周期为3周，模拟ES-SCLC患者采用贝莫苏拜单抗联合安罗替尼和化疗方案或单纯化疗方案治疗10年的总成本、质量调整生命年（QALY）及增量成本-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模型的稳健性。意愿支付（WTP）阈值为3倍2023年我国人均国内生产总值（GDP），即268 074元/QALY。

结果

相比于单纯化疗方案，贝莫苏拜单抗联合安罗替尼和化疗方案可多获得0.438 QALY，成本则高出403 505.55元，ICER为922 031.37元/QALY，高于本研究设定的WTP阈值。单因素敏感性分析结果显示，贝莫苏拜单抗成本、无进展生存期状态的效用值及贴现率对基础分析结果的影响较大；概率敏感性分析结果证实该模型稳健，且贝莫苏拜单抗降价75.4%时，联合方案才具有经济性。

结论

从我国卫生体系角度出发，贝莫苏拜单抗联合安罗替尼和化疗方案一线治疗ES-SCLC当前不具有经济性。

Abstract

OBJECTIVE

To evaluate the cost-utility of benmelstobart combined with anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer （ES-SCLC） from the perspective of China’s healthcare system.

METHODS

Based on the data from the ETER 701 study， a partitioned survival model was constructed with a cycle of 3 weeks to simulate the total cost， quality-adjusted life years （QALY）， and incremental cost-effectiveness ratio （ICER） over 10 years for patients with ES-SCLC treated with benmelstobart plus anlotinib and chemotherapy， or chemotherapy alone. One-way sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the simulation results. The willingness-to-pay （WTP） threshold was set at 3 times the per capita gross domestic product （GDP） of China in 2023， which amounted to 268 074 yuan/QALY.

RESULTS

Compared with chemotherapy alone， benmelstobart combined with anlotinib and chemotherapy gained 0.438 QALY more at the cost of 403 505.55 yuan more， with an ICER of 922 031.37 yuan/QALY， which was higher than the WTP threshold set in this study. One-way sensitivity analysis showed that benmelstobart’s cost and utility value of the progression-free survival state had a greater impact on the ICER value； probabilistic sensitivity analysis confirmed the robustness of the model； only when the price of benmelstobart was reduced by 75.4%， the combined regimen would be cost-effective.

CONCLUSIONS

The first-line treatment of ES-SCLC with benmelstobart combined with anlotinib and chemotherapy is not cost-effective from the perspective of China’s healthcare system at present.

关键词

Keywords

references

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