非小细胞肺癌靶向治疗前间变淋巴瘤激酶伴随诊断方法的经济学分析

发布时间：2018-06-03 12:22

本文选题：非小细胞肺癌 + 间变淋巴瘤激酶　；参考：《中国卫生经济》2017年01期

【摘要】：目的:对非小细胞肺癌(NSCLC)患者进行个体化医疗,分析采用各种检测方法分类诊断后指导靶向治疗的健康结果与经济性。方法:建立决策树模型,分别模拟3组10万名NSCLC患者队列用国内指南推荐的3种间变淋巴瘤激酶(ALK)确诊检测方法(FISH、Ventana IHC和RT-PCR),阳性者使用克唑替尼作为一线治疗,计算5年内发生的医疗成本和获得的健康效果,然后进行成本效果分析;临床和经济学结果的数据主要来源于文献报告。结果:以2014年3倍上海人均GDP为阈值(292 110元人民币),Ventana IHC指导用药组相较PCR组成本更低,效果更好,因此Ventana IHC组处于优势地位;FISH组相较于Ventana IHC组的ICER为1 091 727元/QALY,远大于阈值,故Ventana IHC组比FISH组更具有成本效果。结论:在3种诊断ALK的检测方法中,建议优先将Ventan IHC伴随诊断方法纳入NSCLC靶向治疗的疾病管理方案。
[Abstract]:Objective: to analyze the health outcomes and economics of targeted therapy in NSCLC patients with NSCLC. Methods: a decision tree model was established, and three cohorts of 100000 NSCLC patients were simulated using three diagnostic methods, including FISHX Ventana IHC and RT-PCRV, as recommended by the domestic guidelines. The positive patients were treated with kazotinib as the first line therapy. The medical costs and health effects obtained in 5 years were calculated, and then the cost effect analysis was carried out. The data of clinical and economic results were mainly derived from the literature reports. Results: compared with PCR group, the GDP per capita in 2014 was 3 times that in Shanghai. The ICER of the Ventana IHC group was higher than that of the Ventana IHC group, and the ICER of the Ventana IHC group was 1 091,727 yuan / QALYA, which was much higher than that of the PCR group. Therefore, Ventana IHC group is more cost effective than FISH group. Conclusion: among the three diagnostic methods for ALK, it is suggested that Ventan IHC adjoint diagnosis should be included in the disease management scheme of NSCLC targeted therapy.
【作者单位】：上海市医学科学技术情报研究所上海市卫生发展研究中心;复旦大学公共卫生学院;罗氏诊断产品(上海)有限公司;北京大学肿瘤医院;
【分类号】：R734.2

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