【摘要】 目的:评价奥拉帕利相比化疗药在人表皮生长因子受体-2（HER2）阴性转移性乳腺癌治疗中的经济性。方法:根据HER2阴性转移性乳腺癌的疾病进展和转归，基于国外一项已发表的Ⅲ期临床研究，选择Markov模型对奥拉帕利和化疗药两种治疗方案进行经济学的评价，模型中包括无进展状态、进展状态和死亡。采用单因素敏感性分析和概率敏感性分析评价模型参数变化对结果稳定性的影响。结果:奥拉帕利组较之化疗药组的增量成本-效果比（ICER）值为2 377 827.78元·（质量调整生命年）^-1。奥拉帕利单价、化疗药组接受艾立布林治疗的患者比例是对该模型影响较大的参数。结论:相比化疗药，奥拉帕利的ICER远超意愿支付阈值，不具有成本-效用优势。更多还原

【Abstract】 Objective: To compare the economic effectiveness of olaparib with chemotherapy in the treatment of human epidermal growth factor receptor 2(HER2) negative metastatic breast cancer. Methods: Based on a published phaseⅢ randomized clinical controlled trial and according to the disease progression of patients with metastatic breast cancer, the Markov model was established and used to evaluate the economic effectiveness of the two treatments. The model included three health states, i.e., non-progressive free survival state, disease progress state and death state. One-way sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the influence of model parameter changes on the robustness of the results. Results: The incremental cost effectiveness ratio(ICER) value in olaparib group versus chemotherapy group was 2377827.78 yuan/quality-adjusted life year(QALY). The sensitivity analysis showed that the olaparib unit price and the proportion of patients in chemotherapy group treated with Eribulin were the most influential parameters in the model. Conclusion: The incremental cost-effectiveness ratio of the olaparib far exceeds the established willingness to pay(WTP) compared with the chemotherapy group, and the olaparib has no cost-effectiveness advantage.更多还原