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目的 探究依沃西单抗联合化疗应用于表皮生长因子受体酪氨酸激酶抑制剂治疗后进展的非鳞状非小细胞肺癌患者的经济性，为相关卫生保健政策的制订奠定基础。方法 纳入表皮生长因子受体酪氨酸激酶抑制剂治疗失败的非鳞状非小细胞肺癌病例322例，随机分为依沃西单抗组和对照组各161例。建立分区生存模型，从国家卫生健康系统视角出发，测算2组治疗总费用、质量调整生命年和增量成本-效果比。采用单因素和概率敏感性分析，评估模型稳定性。结果 161例病例的治疗总成本为(111 785±18 999)元，质量调整生命年为0.624。对照组的平均治疗总成本为30 289元，质量调整生命年为0.402。与对照组比较，依沃西单抗组的增量成本-效果比为366 961.7元·QALY-1，远高于国内意愿支付阈值(268 074元·QALY-1)。结论 目前，与单独化疗比较，采用依沃西单抗联合化疗治疗表皮生长因子受体酪氨酸激酶抑制剂进展后非鳞状非小细胞肺癌患者的经济性欠佳。
Abstract：AIM To assess the cost-effectiveness of ivonescimab combined with chemotherapy compared with chemotherapy alone in non-squamous non-small cell lung cancer(NSCLC) patients with disease progression after EGFRtyrosine kinase inhibitor(EGFR-TKI) therapy, and to lay a foundation for healthcare policy formulation. METHODS A total of 322 NSCLC patients with prior EGFR-TKI treatment failure were included and randomly assigned to the ivonescimab group or the control group, with 161 patients in each group. The total cost, quality-adjusted life years(QALYs), and incremental cost-effectiveness ratio(ICER) for the 2 groups were calculated using a partitioned survival model from the perspective of the national health system, and the model's stability was evaluated through single-factor and probabilistic sensitivity analyses. RESULTS In the treatment of ivonescimab combined with chemotherapy, the total cost of treatment was ¥(111 785 ± 18 999), with 0.624 QALYs gained. The average total cost for patients in the control group was ¥ 30 289, with 0.402 QALYs gained. Compared with the control group, the ICER of the ivonescimab group was ¥ 366 961.7 per QALY, which was much higher than the domestic willingness-to-pay threshold(¥ 268 074 per QALY). CONCLUSION Based on the Chinese health system, ivonescimab combined with chemotherapy is not a cost-effective option compared with chemotherapy alone for the treatment of non-squamous NSCLC patients with disease progression after EGFR-TKI therapy.
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基本信息:
DOI：10.19577/j.1007-4406.2026.03.005
中图分类号:R734.2
引用信息:
[1]蒋媛,王美飒,高靓,等.依沃西单抗联合化疗治疗表皮生长因子受体酪氨酸激酶抑制剂治疗后进展的非鳞状非小细胞肺癌的成本-效用分析[J].中国临床药学杂志,2026,35(03):217-223.DOI:10.19577/j.1007-4406.2026.03.005.
基金信息:
天津市卫生健康委2024年天津市药品临床综合评价项目（编号TZH-2024-005）; 天津市自然科学基金自主立项项目（编号24JCQNJC01900）
2026-03-25
2026-03-25