摘要
目的:从中国卫生体系角度评价多纳非尼与索拉非尼一线治疗不可切除或转移性肝细胞癌(HCC)的经济性。方法:基于一项Ⅱ~Ⅲ期临床试验数据,通过R语言将数据重新拟合,并构建分区生存模型,以增量成本-效果比(ICER)为评价指标,比较多纳非尼与索拉非尼的经济性。对成本和效用值进行5%的贴现,使用敏感性分析验证结果的稳定性。结果:模型运行终点显示,多纳非尼相对于索拉非尼每增加一个质量调整生命年(QALYs),需要多花费91861.42元,低于中国2022年3倍人均GDP。敏感性分析结果显示,索拉非尼与多纳非尼成本对结果影响较大;当意愿支付值(WTP)为中国2022年3倍人均GDP时,多纳非尼具有经济性的概率为89.7%。结论:多纳非尼相对于索拉非尼一线治疗不可切除或转移性HCC具有经济性。
OBJECTIVE To evaluate the cost-effectiveness of first-line treatment of unresectable or metastatic hepatocellular carcinoma(HCC)with donafenib versus sorafenib from the perspective of China health system.METHODS Based upon a phaseⅡ-Ⅲclinical trial,raw data were refitted by R language and a partitioned survival model was constructed for comparing the economics of donafenib versus sorafenib using incremental cost-effectiveness ratio(ICER)as an evaluation metric.After discounting cost and utility values by 5%,sensitivity analysis was performed for verifying the stability of the results.RESULTS At the end of modeling,each additional quality-adjusting life years(QALYs)of donafenib versus sorafenib cost 91861.42 yuan.It was lower than per capita gross domestic product(GDP)of China in 2022 by three folds.The results of sensitivity analysis indicated that cost of sorafenib versus donafenib had great impact on the results.When willing-to-pay(WTP)tripled per capita GDP of China in 2022,the economical probability of donafenib was 89.7%.CONCLUSION Donafenib is more economical than sorafenib as a first-line treatment for unresectable or metastatic HCC.
作者
居文祥
张小涵
赵荧荧
路萝兰
沈爱宗
JU Wenxiang;ZHANG Xiaohan;ZHAO Yingying;LU Luolan;SHEN Aizong(College of Pharmacy,Anhui University of Chinese Medicine,Anhui Hefei 230012,China;Anhui Technology Center for Clinical Comprehensive Evaluation of Drugs,Anhui Hefei 230001,China;Department of Pharmacy,Anhui Provincial Hospital,First Affiliated Hospital,University of Science&Technology of China,Anhui Hefei 230001,China)
出处
《中国医院药学杂志》
CAS
北大核心
2024年第8期946-950,共5页
Chinese Journal of Hospital Pharmacy
