瑞波西利联合氟维司群二线治疗绝经后HR+/HER2-晚期转移性乳腺癌的药物经济学评价

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【中图分类号】R737.9；R956 【文献标识码】A

【Abstract】 Objective To evaluate the cost-effectiveness of the combination therapy of ribociclib plus fulvestrant compared to fulvestrant monotherapy as a second-line treatment for postmenopausal patients with hormone receptor-positive （HR+） ）/human epidermal growth factor receptor 2-negative （HER2-）advanced metastatic breast cancer from the perspective of the Chinese healthcare system. Methods A partitioned survival model was constructed based on MONALEESA-3 study data， with the model cycle of 4 weeks and the time range of 15 years. Total cost， quality-adjusted life years （QALYs） and incremental cost-efectivenessratio （ICER） were compared between ribociclib combined with fulvestrant and fulvestrant monotherapy as a second-line treatment for postmenopausal patients with HR .+ /HER2-advanced metastatic breast cancer. The robustness of the models was validated through one-way sensitivity analysis and probabilistic sensitivity analysis.Results Compared with the fulvestrant monotherapy regimen，the ICER for the ribociclib combined with fulvestrant regimen was 187，958.06 yuan/QALY， which was below the willingness-to-pay （WTP） threshold of three times China’s per capita gross domestic product （GDP） in 2024 （287，247 yuan/QALY）.The one-way sensitivityanalysis revealed that the ICER was primarily influenced by the proportion of patients receiving subsequent treatments with the combination therapy or fulvestrant monotherapy，and the utility value of progression-free survival.The probabilistic sensitivity analysis showed that at a WTP threshold of thre times China’s per capita GDP in China in 2024 （287，247 yuan/QALY）， the probability of the ribociclib combination therapy being cost-effective was 100% .Conclusion In the context of the Chinese healthcare system， the combination therapy of ribociclib and fulvestrant is more cost-effective than fulvestrant monotherapy for the second-line treatment of postmenopausal patients with HR+ /HER2- advanced metastaticbreast cancer.

【KeyWords】Ribociclib; Fulvestrant; Advanced breast cancer; Postmenopausal; Pharmacoeconomic evaluation; Cost-effectiveness analysis

激素受体 阳性（hormone receptor-positive，HR+ ）/人表皮生长因子受体2阴性（humanepidermal growth factorreceptor2-negative，HER2-）的乳腺癌亚型占所有乳腺癌的 65%～75%[1] 。（剩余16263字）