Cost-Effectiveness Analysis Of Pembrolizumab In The Treatment Of Advanced Recurrent Metastatic Head And Neck Squamous Cell Carcinoma In China And The United States
Cost-Effectiveness Analysis Of Pembrolizumab In The Treatment Of Advanced Recurrent Metastatic Head And Neck Squamous Cell Carcinoma In China And The United States
复制标题
帕博利珠单抗治疗中美晚期复发转移性头颈鳞癌的成本效果分析
DOI：
10.2147/cmar.s226243
复制
发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Li, Na
中科院分区：
文献类型：
--
作者：
Liu, Maobai;Han, Sijie;Li, Na
Pembrolizumab是一种程序性细胞死亡-1（PD-1）抑制剂，最近作为复发性和/或转移性头颈部鳞状细胞癌（R/M HNSCC）的二线治疗获得了重视。本研究比较了帕博利珠单抗在发达国家（即，美国）和发展中国家（即，中国）国家进行成本-效果分析，为临床决策提供有价值的建议。方法采用TreeAge Pro 2015软件构建马尔可夫模型，评价4种治疗策略的经济价值。以质量调整生命年（QALY）和增量成本效果比（ICER）作为增量成本效果分析的经济学指标。通过单因素敏感性分析和概率敏感性分析评价了模型的稳定性。结果在中国和美国，pembrolizumab组与PD-L1 CPS治疗的ICER分别为7892美元/QALY和11,900美元/QALY。在中国，所有ICER均低于29，306美元的门槛，在美国低于50，000美元;因此，帕博利珠单抗具有成本效益。敏感性分析证实了帕博利珠单抗单药方案在中国和美国具有稳定的经济优势。结论在中国和美国，与标准、PD-L1 TPS和PD-L1 CPS组相比，Pembrolizumab单药治疗作为R/M HNSCC的二线治疗具有更多的健康益处。
Background Pembrolizumab, a programmed cell death-1 (PD-1) inhibitor, has recently gained prominence as a second-line treatment for recurrent and/or metastatic head and neck squamous cell cancer (R/M HNSCC). This study compares the acceptance and different influencing factors of pembrolizumab in the treatment of R/M HNSCC in developed (i.e., the United States) and developing (i.e., China) countries through cost-effectiveness analysis and provides valuable suggestions for clinical decision making. Methods A Markov model was constructed using TreeAge Pro 2015 software to evaluate the economic value of four treatment strategies. Quality-adjusted life years (QALY) and incremental cost-effectiveness ratio (ICER) were used as economic indicators for incremental cost-effectiveness analysis. The stability of the model was evaluated by one-way sensitivity and probability sensitivity analyses. Results The ICERs for the pembrolizumab group versus PD-L1 CPS treatment in China and the US were $7892/QALY and $11,900/QALY, respectively. All ICERs were less than the threshold of $29,306 in China and $50,000 in the US; thus, pembrolizumab is cost effective. Sensitivity analysis confirmed a stable economic advantage in the single-drug regimen of pembrolizumab in China and the US. Conclusion Pembrolizumab monotherapy as a second-line treatment for R/M HNSCC presents more health benefits in comparison with the standard, PD-L1 TPS and PD-L1 CPS groups in China and the US.