【摘要】 目的 从中国卫生体系角度出发，评价瑞齐替尼对比吉非替尼一线治疗表皮生长因子受体（EGFR）突变阳性晚期非小细胞肺癌（NSCLC）的经济性。方法 基于REZOR试验数据构建Markov模型，设定模型周期为3周，研究时限为5年。成本与健康产出均采用5%的年贴现率。采用成本-效用分析法，以3倍我国2024年人均国内生产总值作为意愿支付（WTP）阈值，通过增量成本-效果比（ICER）和增量净货币收益（INMB）评估瑞齐替尼方案对比吉非替尼方案的经济性差异，并采用敏感性分析和情境分析验证模型的稳健性。结果 与吉非替尼方案相比，瑞齐替尼方案可节省成本225 310.47元，并额外获得0.57个质量调整生命年（QALY），由此产生的ICER为-395 562.80元/QALY，远小于本研究的WTP阈值，表明瑞齐替尼方案具有绝对经济性优势；INMB分析结果（389 041.26元）进一步验证了这一结论。单因素敏感性分析和概率敏感性分析均证实模型稳健性良好。情境分析通过将药品价格降低15%及调整无进展生存与疾病进展状态的效用值，所得结论与基础分析结果保持一致。结论 与吉非替尼比较，瑞齐替尼作为EGFR突变阳性晚期NSCLC的一线治疗方案具有绝对经济性优势。更多还原

【Abstract】 OBJECTIVE To evaluate the cost-effectiveness of rezivertinib versus gefitinib as first-line treatment for epidermal growth factor receptor(EGFR) mutation-positive advanced non-small cell lung cancer(NSCLC) from the perspective of the Chinese healthcare system. METHODS A Markov model was constructed based on the REZOR trial data, with a cycle length of 3 weeks and a study duration of 5 years. Both costs and health outcomes were discounted at an annual rate of 5%. A cost-utility analysis was conducted using 3 times China’s 2024 per capita gross domestic product as the willingness-to-pay(WTP) threshold. The economic differences between the rezivertinib regimen versus the gefitinib regimen were evaluated using the incremental costeffectiveness ratio(ICER) and incremental net monetary benefit(INMB). Sensitivity and scenario analyses were performed to verify the robustness of the model. RESULTS Compared to the gefitinib regimen, the rezivertinib regimen saved 225 310.47 yuan and gained an additional 0.57 qualityadjusted life years(QALYs), resulting in an ICER of-395 562.80 yuan/QALY, which was much lower than the WTP threshold of this study, indicating that rezivertinib had an absolute economic advantage. The INMB analysis(389 041.26 yuan) further validated this conclusion. One-way and probabilistic sensitivity analyses confirmed the robustness of the model. Scenario analysis, incorporating a 15% reduction in drug prices and adjustments to the utility values for progression free survival and progression disease, yielded consistent results with the base case analysis. CONCLUSIONS Compared to gefitinib, rezivertinib as a first-line treatment for EGFR mutation-positive advanced NSCLC has an absolute economic advantage.更多还原