目的 評(píng)價(jià)卡瑞利珠單抗聯(lián)合化療方案一線治療復(fù)發(fā)或轉(zhuǎn)移性鼻咽癌的經(jīng)濟(jì)性。方法 構(gòu)建分區(qū)生存模型，模擬患者的質(zhì)量調(diào)整生命年（QALY）和增量成本效果比（ICER），并進(jìn)行單因素敏感性分析、概率敏感性分析和情境分析來(lái)檢驗(yàn)?zāi)Ｐ偷牟淮_定性。結(jié)果 基礎(chǔ)分析結(jié)果顯示，相較于傳統(tǒng)安慰劑聯(lián)合化療方案，使用卡瑞利珠單抗聯(lián)合化療方案一線治療復(fù)發(fā)或轉(zhuǎn)移性鼻咽癌的 ICER為 91 570.87元/QALY，遠(yuǎn)低于我國(guó) 3倍人均 GDP；單因素敏感性分析顯示對(duì)模型結(jié)果影響程度最大的3個(gè)因素分別是無(wú)進(jìn)展生存狀態(tài)（PFS）的效用值、卡瑞利珠單抗成本及疾病進(jìn)展后成本；概率敏感性分析顯示，當(dāng)意愿支付值大于15萬(wàn)元，卡瑞利珠單抗對(duì)比安慰劑聯(lián)合順鉑和吉西他濱（GP方案）更具經(jīng)濟(jì)性的概率為100%；情境分析驗(yàn)證了基礎(chǔ)分析的穩(wěn)健性。結(jié)論 在我國(guó)3倍人均GDP的意愿支付值下，使用卡瑞利珠單抗聯(lián)合GP方案一線治療復(fù)發(fā)或轉(zhuǎn)移性鼻咽癌更具經(jīng)濟(jì)性。

Objective To evaluate the economics of the first-line treatment of recurrent or metastatic nasopharyngeal carcinoma with camrelizumab in combination with a chemotherapy regimen.Methods A compartmentalized survival model was constructed to simulate patients' quality-adjusted life-years (QALY) and incremental cost-effectiveness ratios (ICER), and univariate sensitivity analyses, probabilistic sensitivity analyses, and situational analyses were performed to test the model's uncertainty.Results The results of the baseline analysis showed that the ICER for first-line treatment of recurrent or metastatic nasopharyngeal carcinoma using camrelizumab in combination with chemotherapy regimen was 91 570.87 RMB/QALY compared with the traditional placebo combination chemotherapy regimen, which was much lower than three times the per capita GDP in China. The one-way sensitivity analysis showed that the three factors with the greatest degree of influence on the model results were progression-free survival (PFS) status utility value, cost of camrelizumab, and cost after disease progression. Probabilistic sensitivity analysis showed that when the willingness-to-pay value was greater than 150 000 RMB, the probability that camrelizumab was more economical than placebo combined with cisplatin and gemcitabine (GP regimen) was 100%. And situational analysis verified the robustness of the underlying analysis.Conclusion With a willingness-to-pay value of three times our per capita GDP, first-line treatment of recurrent or metastatic nasopharyngeal carcinoma is more economical with the use of camrelizumab in combination with a GP regimen.

R739

福建省衛(wèi)生健康委員會(huì)中青年骨干人才培養(yǎng)項(xiàng)目（2022GGA010）