Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of <italic style="font-style: italic">EGFR-</italic>mutated advanced non-small cell lung cancer

LIANG Miao; LIU Yang; WANG Xianying

doi:10.6039/j.issn.1001-0408.2025.06.13

您当前的位置：

首页 >

文章列表页 >

Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of EGFR-mutated advanced non-small cell lung cancer

更新时间：2025-03-26

- Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of EGFR-mutated advanced non-small cell lung cancer
- ZHONGGUO YAOFANG Vol. 36, Issue 6, Pages: 715-720(2025)
- 作者机构：
  
  河北医科大学第三医院药剂科，石家庄　050051
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.06.13
  CLC： R956;R979.1
- Received：03 July 2024，
  
  Revised：04 March 2025，
  
  Accepted：2025-03-04，
  
  Published：30 March 2025
- 稿件说明：
移动端阅览
梁淼,刘洋,王宪英.埃万妥单抗联合化疗用于EGFR突变的晚期NSCLC的成本- 效果分析 ^Δ[J].中国药房,2025,36(06):715-720.

LIANG Miao,LIU Yang,WANG Xianying.Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of EGFR-mutated advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(06):715-720.
梁淼,刘洋,王宪英.埃万妥单抗联合化疗用于EGFR突变的晚期NSCLC的成本- 效果分析 ^Δ[J].中国药房,2025,36(06):715-720. DOI： 10.6039/j.issn.1001-0408.2025.06.13.

LIANG Miao,LIU Yang,WANG Xianying.Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of EGFR-mutated advanced non-small cell lung cancer[J].ZHONGGUO YAOFANG,2025,36(06):715-720. DOI： 10.6039/j.issn.1001-0408.2025.06.13.

摘要

目的

从中国卫生体系视角，评价埃万妥单抗联合化疗相比于单纯化疗用于在接受奥希替尼单药治疗期间或之后出现疾病进展的

EGFR

突变的晚期非小细胞肺癌（NSCLC）的经济性。

方法

根据MARIPOSA-2试验构建Markov模型，模拟时限设置为10年，循环周期为21 d，计算埃万妥单抗联合化疗相比于单纯化疗治疗

EGFR

突变的晚期NSCLC的增量-成本效果比（ICER），并与本研究设定的意愿支付（WTP）阈值[3倍我国2023年人均国内生产总值（GDP），即268 200元/质量调整生命年（QALY）

]

进行比较，以评估两种治疗方案的经济性；采用单因素敏感性分析和概率敏感性分析以评估模型稳定性；采用情境分析以确定方案具有经济性时的埃万妥单抗价格。

结果

与单纯化疗相比，埃万妥单抗联合化疗方案的成本更高（1 248 411.60元vs. 89 023.39元），但患者的生存获益也更多（0.756 QALY vs. 0.584 QALY），ICER为6 757 285.38元/QALY。无进展生存状态的效用值和埃万妥单抗价格对ICER的影响最大。当埃万妥单抗价格下降至每350 mg 310.3元时，相比于单纯化疗，埃万妥单抗联合化疗方案才开始具有经济性。

结论

从中国卫生体系角度出发，当WTP阈值为3倍我国2023年人均GDP时，埃万妥单抗联合化疗方案较于单纯化疗用于

EGFR

突变的晚期NSCLC不具有经济性；埃万妥单抗价格需大幅下降才能提高患者的可负担性。

Abstract

OBJECTIVE

From the perspective of China’s healthcare system， to evaluate the cost-effectiveness of amivantamab combined with chemotherapy versus chemotherapy alone for patients with

EGFR

-mutated advanced non-small cell lung cancer （NSCLC） who experience disease progression during or after treatment with osimertinib monotherapy.

METHODS

The Markov model was established according to MARIPOSA-2 clinical trial. The simulation time limit was 10 years and the cycle period lasted for 21 days. The incremental cost-effectiveness ratio（ICER） of amivantamab combined with chemotherapy versus chemotherapy alone for the treatment of

EGFR

-mutated advanced NSCLC was calculated， and the

n compared with the willingness-to-pay（WTP） threshold set in this study[3 times the per capita gross domestic product（GDP） of China in 2023， which was 268 200 yuan per quality-adjusted life year（QALY）

]

， in order to assess its cost-effectiveness. Single-factor sensitivity analysis and probability sensitivity analysis were performed to evaluate the stability of the model； scenario analysis was carried out to determine the potential price of amivantamab at which the regimen became cost-effective.

RESULTS

Compared with chemotherapy alone， the cost of amivantamab combined with chemotherapy was higher （1 248 411.60 yuan vs. 89 023.39 yuan）， but at the same time， there were also more benefits of survival （0.756 QALY vs. 0.584 QALY）， ICER was 6 757 285.38 yuan/QALY. ICER was most affected by the utility of progression-free survival and the price of amivantamab. The price of amivantamab decreased to 310.3 yuan per 350 mg， and the combination therapy became cost-effective， compared with chemotherapy alone.

CONCLUSIONS

From the perspective of Chinese health system， when the WTP threshold is set at three times the per capita GDP of the Chinese population in 2023， amivantamab combined with chemotherapy is not cost-effective for

EGFR

-mutated advanced NSCLC； the patients’ affordability can be improved when the price of amivantamab experiences a significant decrease.

关键词

Keywords

references

SHU Y M ， DING Y L ， LI F E ， et al . Cost-effectiveness of nivolumab plus ipilimumab versus chemotherapy as first-line therapy in advanced non-small cell lung cancer [J ] . Int Immunopharmacol ， 2023 ， 114 ： 109589 .

PASSARO A ， WANG J ， WANG Y ， et al . Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib：primary results from the phase Ⅲ MARIPOSA-2 study [J ] . Ann Oncol ， 2024 ， 35 （ 1 ）： 77 - 90 .

SYED Y Y . Amivantamab：first approval [J ] . Drugs ， 2021 ， 81 （ 11 ）： 1349 - 1353 .

中华医学会肿瘤学分会 . 中华医学会肺癌临床诊疗指南：2023 [J ] . 中华医学杂志， 2023 ， 103 （ 27 ）： 2037 - 2074 .

Oncology Society of Chinese Medical Association . Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer：2023 edition [J ] . Natl Med J China ， 2023 ， 103 （ 27 ）： 2037 - 2074 .

刘国恩 . 中国药物经济学评价指南2020 [M ] . 北京：中国市场出版社， 2020 ： 36 - 46 .

LIU G E . Chinese pharmacoeconomic evaluation guidelines 2020 [M ] . Beijing ： China Market Publishing House ， 2020 ： 36 - 46 .

YOU M ， CHEN R ， WU Q ， et al . Cost-effectiveness analysis of adebrelimab combined with chemotherapy for extensive-stage small cell lung cancer [J ] . Front Pharmacol ， 2022 ， 13 ： 1019826 .

汤雅倩，赵明烨，唐文熙 . 信迪利单抗对比卡瑞利珠单抗一线治疗晚期非鳞状非小细胞肺癌的经济学评价 [J ] . 卫生经济研究， 2023 ， 40 （ 2 ）： 34 - 40 .

TANG Y Q ， ZHAO M Y ， TANG W X . Pharmacoeconomic evaluation of sintilimab versus camrelizumab in the first-line treatment of patients with non-squamous advanced non-small cell lung cancer in China [J ] . Health Econ Res ， 2023 ， 40 （ 2 ）： 34 - 40 .

洪望龙，夏一淼，苏广全，等 . 达可替尼对比吉非替尼一线治疗表皮生长因子受体突变晚期非小细胞肺癌的成本-效果分析 [J ] . 中国医院药学杂志， 2023 ， 43 （ 8 ）： 925 - 930 .

HONG W L ， XIA Y M ， SU G Q ， et al . Cost-effectiveness analysis of dacomitinib versus gefitinib in first line treatment of advanced non-small cell lung cancer with epidermal growth factor receptor mutation [J ] . Chin J Hosp Pharm ， 2023 ， 43 （ 8 ）： 925 - 930 .

史健，齐冉，高胜男，等 . 度伐利尤单抗用于Ⅲ期非小细胞肺癌放化疗后巩固治疗的成本-效用分析 [J ] . 中国药房， 2022 ， 33 （ 15 ）： 1860 - 1864 .

SHI J ， QI R ， GAO S N ， et al . Cost-utility analysis of durvalumab for consolidation therapy after chemoradiotherapy for stage Ⅲ nonsmall cell lung cancer [J ] . China Pharm ， 2022 ， 33 （ 15 ）： 1860 - 1864 .

孙蕾，周大创，陈平钰，等 . 恩沙替尼一线治疗间变性淋巴瘤激酶阳性晚期非小细胞肺癌的药物经济学评价 [J ] . 中国药房， 2022 ， 33 （ 12 ）： 1479 - 1484 .

SUN L ， ZHOU D C ， CHEN P Y ， et al . Pharmacoeconomic evaluation of ensatinib in the first-line treatment of anaplastic lymphoma kinase-positive advanced non-small cell lung cancer [J ] . China Pharm ， 2022 ， 33 （ 12 ）： 1479 - 1484 .

耿魁魁，徐文，吴凤芝，等 . 注射用曲妥珠单抗分剂量调配、收费和报销模式的建立与应用 [J ] . 中国药房， 2020 ， 31 （ 23 ）： 2914 - 2917 .

GENG K K ， XU W ， WU F Z ， et al . Establishment and application of dispensing，charging and reimbursement mode by dose of trastuzumab for injection [J ] . China Pharm ， 2020 ， 31 （ 23 ）： 2914 - 2917 .

刘慧，闫峻峰，朱九群，等 . 通过优化药品规格减少静脉化疗药物浪费的效果分析 [J ] . 中国药物应用与监测， 2022 ， 19 （ 6 ）： 409 - 412 .

LIU H ， YAN J F ， ZHU J Q ， et al . Effect analysis of redu-cing waste of intravenous chemotherapy drugs by optimi-zing drug specification [J ] . Chin J Drug Appl Monit ， 2022 ， 19 （ 6 ）： 409 - 412 .

苏广全，易仁平，方苹苹，等 . 伏美替尼对比吉非替尼单药一线治疗表皮生长因子受体突变晚期非小细胞肺癌的成本-效果分析 [J ] . 医药导报， 2024 ， 43 （ 8 ）： 1245 - 1251 .

SU G Q ， YI R P ， FANG P P ， et al . Cost-effectiveness analysis of furmonertinib compared to gefitinib in first-line monotherapy for advanced non-small cell lung cancer with EGFR mutation [J ] . Her Med ， 2024 ， 43 （ 8 ）： 1245 - 1251 .

陈叶莉，龙云春，陈方，等 . 度伐利尤单抗对比阿替利珠单抗一线治疗广泛期小细胞肺癌的成本-效果分析 [J ] . 中国医院药学杂志， 2024 ， 44 （ 7 ）： 815 - 821 .

CHEN Y L ， LONG Y C ， CHEN F ， et al . Cost-effectiveness analysis of durvalumab versus atezolizumab as a first-line treatment for extensive-stage small cell lung cancer [J ] . Chin J Hosp Pharm ， 2024 ， 44 （ 7 ）： 815 - 821 .

WARD M C ， SHAH C ， ADELSTEIN D J ， et al . Cost-effectiveness of nivolumab for recurrent or metastatic head and neck cancer [J ] . Oral Oncol ， 2017 ， 74 ： 49 - 55 .

何银梅，李晓，刘晓丽，等 . 戈沙妥珠单抗对比单药化疗后线治疗HR+/HER2－晚期转移性乳腺癌的成本-效用分析 [J ] . 中国药房， 2024 ， 35 （ 20 ）： 2493 - 2498 .

HE Y M ， LI X ， LIU X L ， et al . Cost-utility analysis of sacituzumab govitecan versus single-agent chemotherapy in the treatment of HR+/HER2－ advanced metastatic breast cancer [J ] . China Pharm ， 2024 ， 35 （ 20 ）： 2493 - 2498 .

YUE P ， ZHANG M ， FENG Y ， et al . Cost-effectiveness analysis of amivantamab plus chemotherapy versus chemotherapy alone in NSCLC with EGFR exon 20 insertions [J ] . Front Oncol ， 2024 ， 14 ： 1368804 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Cost-effectiveness analysis of gonadotropin-releasing hormone analogue combined with recombinant human growth hormone in the treatment of central precocious puberty

Clinical evaluation of elderly patients with sarcopenia receiving Shenling baizhu powder combined with nutrition and exercise intervention

Cost-effectiveness analysis of apatinib combined with adriamycin for second-line treatment of platinum-resistant recurrent ovarian cancer

Cost-effectiveness analysis of tislelizumab combined with chemotherapy as first-line treatment for locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma

Cost-effectiveness analysis of serplulimab combined with chemotherapy as first-line treatment for advanced esophageal squamous cell carcinoma

Related Author

ZHANG Lingli

WU Jin

ZENG Linan

LIU Zheng

LIU Jianing

YANG Chunsong

CHEN Dong

JIANG Huanhuan

Related Institution

Evidence-based Medicine Center， West China Hospital， Sichuan University

Molecular Translational Medicine Laboratory， Translational Medicine Center， Sichuan University

Dept. of Pediatrics， West China Second Hospital， Sichuan University

West China Clinical Medical College， Sichuan University

Key Laboratory of Birth Defects and Related Diseases of Women and Children， Ministry of Education

Address：8th Floor, Sihuan Building, No. 129 Daping Main Street, Yuzhong District, Chongqing, China Postal code：400042
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰

Analysis of cost-effectiveness of amivantamab combined with chemotherapy in the treatment of EGFR-mutated advanced non-small cell lung cancer

DOI：10.6039/j.issn.1001-0408.2025.06.13

摘要

Abstract

关键词

Keywords

references