NALIRIFOX方案一线治疗转移性胰腺癌的经济学评价

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中图分类号 R956；R979.1 文献标志码A 文章编号 1001-0408（2025）21-2681-06

DOI 10.6039/j.issn.1001-0408.2025.21.11

ABSTRACTOBJECTIVEFrom the perspectiveof China's health system，toevaluate theeconomiceficiencyof Irinotecan liposome+fluorouracil+calciumfolinate+oxaliplatin（NALIRIFOXregimen）versuspaclitaxel（albumin-bound）combinedwith gemcitabie（AGregimen）inthefirst-linetreatmentof metastaticpancreaticcancerMETODSAdynamicMarkovmodelwas constructedbasedonthedatafromtheNAPOLI3clinical trial，withacyeleperiodof28daysandasimulationtimelimitof 5 years.Incrementalcost-effectivenessratio（ICER）andquality-adjustedlifeyear（QALY）wereusedasthemodeloutputindicators. The willigness-to-pay（WTP）threshold wassetatthreetimes China’s2024percapita gross domesticproduct（GDP），and a discount rate of 5% wasadopted.A cost-utility analysis was conducted to analyze the economic eficiencyof the NALIRIFOX regimenomparedtotheAGregimen.Univariatesensitivityanalysisandprobabilisticsensitivityanalysis wereusedtoevaluate the robustness of the model results，and scenarioanalysis wasconducted byreducing thecostof irinotecan liposome by 60% and 70% 业 RESULTS The base-case analysis showed thatthe ICER of the NALIRIFOX regimen was 854 69.96 yuan/QALYcompared to the AG regimen，which was greater than the WTPthreshold（287 247yuan/QALY），indicating that theNALIRIFOXregimen was not economicallyeficient.Theunivariatesensitivityanalysisresultsindicatedthatthediscountrate，thecostofirinotecanliposome， theutityvalueofteprogresion-freesurvivalstateandteutilityvalueofthediseaseprogressionstateadasignificatpact onthe ICER.TheprobabilisticsensitivityanalysisresultsshowedthatundertheWTPthresholdofthisstudy，theNALIRIFOX regimenwas noteconomicallyeficientcompared withtheAGregimen.Thescenarioanalysis results indicatedthat whenthe price wasreduced by 70% ，the probability of the NALIRIFOX regimen being economically effcient compared with the AG regimen was 9.60% .CONCUSIONSFrom the perspectiveof China’s health system，when theWTP thresholdissetatthree times China’s2024 per capita GDP，the NALIRIFOX regimen isnot economically efficient in the first-line treatment of metastatic pancreatic cancer，compared with theAG regimen.

KEYWORDSIrinotecan liposome；NALIRIFOX regimen;metastatic pancreatic cancer； first-line treatment； Markovmodel；pharmacoeconomics；cost-utilityanalysis

近年来，胰腺癌已成为全球范围内发病率和死亡率上升最快的恶性肿瘤之一。（剩余10804字）