转移性结直肠癌3种一线化疗方案的药物经济学评价

发布时间：2018-07-03 05:06

本文选题：结直肠癌 + 化疗方案　；参考：《中国医院药学杂志》2017年22期

【摘要】：目的:探讨转移性结直肠癌(mCRC)3种一线化疗方案的药物经济学效果及影响因素。方法:采用回顾性调查方法,纳入2012年1月1日-2015年10月30日期间符合纳入标准的mCRC患者,根据化疗方案不同分为FOLFOX组、CapeOx组和FOLFIRI组。以总住院费用为成本,无进展生存时间(PFS)为效果,对3种化疗方案进行成本-效果分析和敏感度分析,并评价化疗药物是否国产及医保支付对结果的影响。结果:共纳入678名患者,FOLFOX组(136例)、CapeOx组(392例)和FOLFIRI组(150例)间基本情况无统计学差异(P0.05),具有可比性。FOLFOX组、CapeOx组和FOLFIRI组PFS分别为154.15 d、156.16 d和165.84 d,不良反应各组间无统计学差异,总治疗费用分别为63 956.11元、73 826.06元和79 259.20元,成本-效果比分别为414.90、472.76和477.93。在FOLFOX方案的基础上,每增加一天PFS,FOLFIRI方案和CapeOx方案所追加的成本分别为57.86元和59.69元。敏感度分析结果与成本-效果分析一致。亚组分析表明,国产药物的效果略低于进口药物,成本均高于进口药物,成本-效果比低于进口药物,药物经济学效果好。3种方案患者自付费用成本-效果比FOLFOX方案CapeOx方案FOLFIRI方案,医保支付费用成本-效果比FOLFOXFOLFIRICapeOx。结论:mCRC3种一线化疗方案中,成本最低的为FOLFOX方案,效果最佳的为FOLFIRI方案,经济学效果最优为FOLFOX方案。
[Abstract]:Objective: to investigate the pharmacoeconomic effects and influencing factors of three first-line chemotherapy regimens for metastatic colorectal cancer (mCRC). Methods: according to the chemotherapy regimen, mCRC patients who met the inclusion criteria from January 1, 2012 to October 30, 2015 were divided into FOLFOX group (CapeOx group) and FOLFIRI group (FOLFOX group). Taking total hospitalization cost as the cost and PFS as the effect, the cost-effect analysis and sensitivity analysis of three chemotherapy regimens were carried out, and the effects of domestic chemotherapeutic drugs and medical insurance payment on the results were evaluated. Results: there was no statistical difference between the two groups (P 0.05). The PFS of CapeOx group (392 cases) and FOLFIRI group (150 cases) were comparable (P0.05). The PFS of CapeOx group and FOLFIRI group were 154.15 days 156.16 days and 165.84 days, respectively. The total cost of treatment was 63 956.11 yuan 73 826.06 yuan and 79 259.20 yuan respectively. The cost-effectiveness ratio was 414.90472.76 and 477.93 respectively. On the basis of FOLFOX scheme, the additional cost of PFSU FOLFIRI scheme and CapeOx scheme is 57.86 yuan and 59.69 yuan respectively. Sensitivity analysis results are consistent with cost-effect analysis. Subgroup analysis showed that the effect of domestic drugs was slightly lower than that of imported drugs, and the cost was higher than that of imported drugs, and the cost-effect ratio was lower than that of imported drugs. Pharmacoeconomics is better than FOLFOX, CapeOx, FOLFIRI, and Medicare, which is more effective than FOLFOXFOLFIRICapeOx. Conclusion the lowest cost is FOLFOX, the best is FOLFIRI, and the best in economics is FOLFOX.
【作者单位】：南京医科大学第一附属医院药学部;
【基金】：江苏省药学会奥赛康临床药学基金(编号:201308)
【分类号】：R956

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