OBJECTIVE To provide suggestions and references for promoting the economic efficiency of anti -AIDS drug use in China .METHODS According to the Chinese Guidelines for the Diagnosis and Treatment of AIDS （2021 Edition）and the National Free HIV Antiretroviral Drug Treatment Manual （4th Edition ），non-free anti -HIV drugs and therapeutic regimens were screened；the data on domestic and foreign drug prices were collected ，and the price and affordability of non -free anti -HIV drugs and drug regimens were analyzed with the median price ratio （MPR）method and drug affordability study method by standard survey method . RESULTS A total of 18 non-free anti -HIV drugs （based on drug names ）were screened ，of which 5 drugs were only domestically produced ，11 were only imported ，and 2 were both domestic and imported drugs ；eight types were listed in the Basic Medical Insurance Catalogue （2021 Edition）. The median MPR for 18 drugs was 0.504，and drugs with affordability of less than 1 accounted for 55% of the total number of drugs before medicare reimbursement ，and this figure increased to 75% after medicare reimbursement . The median affordability after reimbursement of 10 single-tablet combinations was 0.625，of which the affordability of the four single -tablet combinations recommended by the guidelines for use alone was less than 1. There was no statistically significant difference in the affordability of two regimens before and after medicare reimbursement and between recommended regimens and alternatives after reimbursement （P＞0.05）. CONCLUSIONS The affordability of single non -free anti - HIV drugs in China is good ，but the affordability of combination drugs is poor . The affordability advantages of single -tablet combination formulations over conventional therapeutic regimens are significant . The government and enterprises should focus on the research and development of innovative drugs and strengthen drug price control ，and establish and improve the non -free drug protection system for HIV/AIDS groups ，so that they can choose more drugs and use drugs more economically .

OBJECTIVE To evaluate the cost-effectiveness of pembrolizumab combined with chemotherapy versus placebo combined with chemotherapy in the first-line treatment of advanced or unresectable biliary tract carcinoma （BTC） from the perspective of China’s health system. METHODS A partitioned survival model was constructed based on the KEYNOTE-966 study data. The simulation period was 21 days， and the simulation time was the patient’s whole life. Using quality-adjusted life year （QALY） as the output indicator， the cost-utility analysis method was used to evaluate the cost-effectiveness of the two schemes mentioned above. Univariate and probabilistic sensitivity analyses were performed to verify the results of the basic analysis， and to explore the cost-effectiveness under the scenario of drug donation scheme. RESULTS The basic analysis showed that both the cost and effectiveness of the pembrolizumab group were higher than those of the placebo group， and the incremental cost-effectiveness ratio （ICER） was 3 909 359.78 yuan/QALY， which was higher than the willingness-to-pay （WTP） threshold of 3 times 2022 gross domestic product （GDP） per capita （257 094 yuan）， indicating no cost-effectiveness. The results of univariate sensitivity analysis showed that the utility discount rate， the utility value of progression-free survival （PFS） status， the cost discount rate， and the cost of pembrolizumab had a great influence on ICER. Probabilistic sensitivity analysis verified the robustness of the results of basic analysis， and concluded that when the WTP threshold was greater than 1 500 000 yuan/QALY， the pembrolizumab group became cost-effective. The results of the scenario analysis showed that considering the drug donation scheme of pembrolizumab for low-income people， although its treatment cost was significantly reduced， it was still not cost-effective. CONCLUSIONS At the WTP threshold of 3 times China’s GDP per capita in 2022， pembrolizumab combined with chemotherapy is not cost-effective compared with placebo combined with chemotherapy for advanced or unresectable BTC.