摘要
目的:评价BEV联合化疗(紫杉醇+卡铂)与单纯化疗对复发性卵巢癌患者的成本效果性。方法:根据复发性卵巢癌患者疾病进展与转归过程,基于GOG-0213试验,选择马尔可夫(Markov)模型对2种化疗方案进行经济学评价。该模型包括三个相互排斥的健康状态:PFS状态、PD状态和death状态。效用值与成本单价参考当地某三甲医院费用标准或文献,并对结果进行敏感度分析。结果:模型运行10年结果显示:BEV的加入使得总成本增加272607.18元(385094.06元vs.112486.88元)。相比标准化疗组,BEV的加入使总效用值增加0.40 QALY(2.19 QALY vs.1.79 QALY),增量成本效果比为681517.95元/QALY。一维敏感性分析分析结果显示:BCP组的PFS、BEV的成本、PD状态效用值是依次为对模型影响最大的参数。概率敏感性分析结果显示:ICER值大于WTP(3倍GDP)的概率为100%。结论:相比标准化疗方案,BEV联合方案的增量成本效果比远远超过设定的意愿支付阈值,因此,考虑到BEV的单位成本以及其所带来的生存获益,BEV联合紫杉醇+卡铂方案不具有成本效果性。
OBJECTIVE To evaluate the cost-effectiveness of BEV combined with chemotherapy(paclitaxel+carboplatin)and chemotherapy alone in patients with recurrent ovarian cancer.METHODS According to the GOG-0213 trial,the Markov model was used to evaluate the economics of the two chemotherapy regimens based on the disease progression and outcome of patients with recurrent ovarian cancer.The model includes three mutually exclusive health states:PFS state,PD state,and death state.The utility value and cost unit price refer to the cost standard or literature of a local level A three hospital,and the sensitivity analysis was peformed based on the results.RESULTS The data from the 10-year model showed that the addition of BEV increased the total cost by 272607.18 yuan(385094.06 yuan vs.112486.88 yuan).Compared with the standard chemotherapy group,the addition of BEV increased the total utility value by 0.40 QALY(2.19 QALY vs.1.79 QALY),and the incremental cost-effectiveness ratio was 681517.95 yuan/QALY.The results of one-dimensional sensitivity analysis show that the cost of PFS,BEV and PD state of BCP group are the most influential parameters for the model.The probability sensitivity analysis results show that the probability of ICER value greater than WTP(3 times GDP)is 100%.CONCLUSION The incremental cost-effectiveness ratio of the BEV combination regimen compared with standard chemotherapy was well above the set willingness-to-pay threshold,so the BEV plus paclitaxel+carboplatin regimen was not cost-effective given the unit cost of BEV and its survival benefit.
作者
陈昭燕
田方圆
徐珽
CHEN Zhao-yan;TIAN Fang-yuan;XU Ting(Department of Clinical Pharmacy,West China Hospital,Sichuan University,Sichuan Chengdu 610041,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第2期189-193,共5页
Chinese Journal of Hospital Pharmacy
基金
中国药学会《医院处方分析合作项目》(编号:312120242).
作者简介
陈昭燕,女,硕士研究生,研究方向:循证药学与药物经济学,电话:028-85422692,E-mail:chenzhaoyan1993@163.com;通讯作者:徐珽,男,博士,主任药师,硕士生导师,研究方向:循证药学和医院药学,电话:028-85422664,E-mail:tingx2009@163.com
