【摘要】 目的 评估特瑞普利单抗联合阿昔替尼对比舒尼替尼一线治疗晚期肾细胞癌的经济性。方法 基于RENOTORCH试验从中国卫生体系角度出发构建分区生存模型，评价特瑞普利单抗联合阿昔替尼对比舒尼替尼一线治疗晚期肾细胞癌的长期成本和健康产出，模拟周期为3周，模拟患者25年的总成本、质量调整生命年(QALYs)和增量成本-效用比(ICUR)。成本来源于药智网2023年平均中标价和已发表文献，健康效用值来源于相关临床试验。贴现率采用5%,意愿支付(WTP)阈值为2022年3倍人均国内生产总值(GDP)。采用单因素和概率敏感性分析检验模型的稳健性。结果 独立审查委员会(IRC)和调查员(IA)评估的无进展生存期(PFS)模拟获得的ICUR值分别为239 436.39元/QALY和175 440.39元/QALY,均低于WTP阈值。单因素敏感性分析显示，PFS状态的健康效用值和阿昔替尼的价格对模型影响较大；概率敏感性分析显示，IRC和IA评估的特瑞普利单抗联合阿昔替尼具有经济性的概率分别为63.64%和98.03%。结论 特瑞普利单抗联合阿昔替尼一线治疗晚期肾细胞癌患者具有经济学优势。更多还原

【Abstract】 Objective To evaluate the cost-effectiveness of toripalimab plus axitinib compared to sunitinib in the first-line treatment of advanced renal cell carcinoma patients. Methods Based on the RENOTORCH trial, constructed a partitioned survival model to evaluate the long-term costs and health outcomes of toripalimab plus axitiniband sunitinib in the first-line treatment of advanced renal cell carcinoma(RCC) patients from the Chinese healthcare system perspective. The cycle length of the model was 3weeks, simulating the total cost, quality adjusted life years(QALYs), and incremental cost-effectiveness ratio(ICUR) for patients over 25 years. The costs were derived from the average bidding price of Yaozhi database in 2023 and published literature. The health state utility values were derived from clinical trials. The discount rate was 5%, and the willingness to pay(WTP) threshold was 3 times the per capita gross domestic product(GDP) in 2022. One-way and probability sensitivity analyses were used to test the robustness of the model. Results Based on the progression free survival(PFS) evaluated by the Independent Review Committee(IRC) and Investigator(IA), the ICUR values were 239 436.39 yuan/QALY and 175 440.39 yuan/QALY, respectively, both lower than the WTP threshold. One-way sensitivity analysis showed that the health state utility values of PFS status and the price of axitinib had a significant impact on the model. Probability sensitivity analysis showed that the probability of toripalimab plus axitinib being cost-effective was 63.64% and 98.03% according to the IRC and IA assessments, respectively. Conclusion Toripalimab plus axitinib was cost-effective in the first-line treatment of advanced RCC patients.更多还原