【摘要】 目的 分析培美曲塞+贝伐珠单抗（Pem-Bev）维持治疗晚期非鳞状非小细胞肺癌的经济性。方法 基于已发表的一项Ⅲ期临床随机对照试验，根据疾病进展历程建立Markov模型，将患者的疾病发展过程归为疾病无进展（PFS）、疾病进展（PD）及死亡（Death）3种状态，对Pem-Bev方案与贝伐珠单抗（Bev）方案进行成本-效果分析，采用单因素敏感性分析和概率敏感性分析法评估模型结果的稳定性。结果 Markov模型输出结果显示，Pem-Bev方案对比Bev方案的增量成本-效果比（ICER）值为562 006.38元/QALY，高于我国患者支付意愿（WTP）阈值（3倍GDP,217 341.00元/QALY）；单因素敏感性分析结果显示，对成本-效果分析结果影响最大的因素依次是PD状态治疗成本、Bev成本、PFS状态效用值；概率敏感性分析结果显示，WTP值为3倍GDP时，Pem-Bev方案具有成本-效果优势的概率为1.91%。结论 与Bev方案相比，Pem-Bev方案维持治疗晚期非鳞状非小细胞肺癌不具有成本-效果优势。更多还原

【Abstract】 Objective To analyze the economy of pemetrexed + bevacizumab(Pem-Bev) in the maintenance therapy of advanced non-squamous non-small-cell lung cancer(NSCLC).Methods Based on a published phase Ⅲ randomized clinical controlled trial,a Markov model was established according to the disease progression process. The disease development process of patients was divided into progression-free survival(PFS),progressive disease(PD) and death. The cost-effectiveness analysis of Pem-Bev regimen and bevacizumab(Bev) regimen were performed,and the stability of the results was evaluated through single factor sensitivity analysis and probability sensitivity analysis.Results The results of Markov model showed that the incremental cost-effectiveness ratio(ICER) in Pem-Bev regimen versus Bev regimen was 562 006. 38 CNY/quality-adjusted life year(QALY),which was higher than the willingness-to-pay(WTP) thresholds(3 times GDP,217 341. 00 CNY/QALY) in China. The results of the single-factor sensitivity analysis showed that the main factor affecting the result of the cost-effectiveness analysis was the cost of PD,followed by the cost of Bev and the utility value of PFS. The results of the probability sensitivity analysis showed that the probability of Pem-Bev with cost-effectiveness advantage was 1. 91% when the WTP was 3 times GDP.Conclusion Compared with Bev regimen,Pem-Bev regimen did not have cost-effectiveness advantage in maintenance therapy of advanced non-squamous NSCLC.更多还原