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SOX方案对比CapeOX方案治疗转移性结直肠癌的成本-效果分析
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| 篇名： | SOX方案对比CapeOX方案治疗转移性结直肠癌的成本-效果分析 |
| TITLE： | |
| 摘要： | 目的：评价SOX方案（替吉奥+奥沙利铂）对比CapeOX方案（卡培他滨+奥沙利铂）治疗转移性结直肠癌的成本-效果，为探索更具经济性的转移性结直肠癌一线治疗方案提供参考。方法：基于已发表的一项高质量的Ⅲ期随机临床对照试验（研究对象系同为亚裔的韩国人），根据转移性结直肠癌患者疾病发展过程建立Markov模型，将模型分为无进展生存状态、疾病进展状态和死亡状态，结合我院的相关数据，对SOX方案与CapeOX方案进行药物经济学成本-效果分析，并用敏感性分析验证模型分析结果的稳定性。结果：根据Markov模型分析结果，相对于标准的CapeOX方案，SOX方案可增加0.14 质量调整生命年（QALYs），同时成本增加35 493.45元，其增量成本-效果比为253 524.64元/QALYs，高于我国的意愿支付阈值（168 201.201元/QALYs）。单因素敏感性分析提示奥沙利铂的费用对成本-效果分析结果的影响最大；概率敏感性分析提示随着我国人均国内生产总值（GDP）的增长，SOX方案具有成本-效果的概率逐渐增加。结论：当前在我国，与标准的CapeOX方案相比，SOX方案治疗转移性结直肠癌不具有成本-效果，不推荐作为转移性结直肠癌一线治疗的首选方案。 |
| ABSTRACT： | OBJECTIVE： To evaluate the cost-effectiveness of SOX regimen （tegafur+oxaliplatin） vs. CapeOX regimen （capecitabine+oxaliplatin） in the treatment of metastatic colorectal cancer， and to provide reference for exploring more economical first-line regimen of metastatic colorectal cancer. METHODS： Based on published high-quality Ⅲ-phase randomized controlled trial， Markov model was established according to the process of disease development in patients with metastatic colorectal cancer. The model was divided into progression-free survival state， progressive disease state and death state. Combined with relevant data of our hospital， pharmacoeconomic cost-effectiveness analysis was conducted for SOX regimen and CapeOX regimen. Sensitivity analysis validation model was used to analyze the stability of the model. RESULTS： According to the results of Markov model operation， compared to standard CapeOX regimen， SOX regimen could increase 0.14 QALYs， and cost increased by 35 493.45 yuan； incremental cost-effectiveness ratio was 253 524.64 yuan/QALYs， which was higher than willingness-to-pay （WTP） threshold （168 201.201 yuan/QALYs）. Single factor sensitivity analysis showed that cost of oxaliplatin had the most important impact on the result of cost-effectiveness analysis. Probabilistic sensitivity analysis depicted that with the increase of GDP per capita， the probability of SOX regimen with cost-effectiveness would increase. CONCLUSIONS： At present， compared with standard CapeOX regimen， SOX regimen has no cost-effectiveness for metastatic colorectal cancer， which is not recommended as the first choice for first-line treatment of metastatic colorectal cancer. |
| 期刊： | 2018年第29卷第6期 |
| 作者： | 秦舟，占美，何治尧，徐珽 |
| AUTHORS： | QIN Zhou，ZHAN Mei，HE Zhiyao，XU Ting |
| 关键字： | SOX方案；CapeOX方案；奥沙利铂；替吉奥；卡培他滨；转移性结直肠癌；成本-效果分析 |
| KEYWORDS： | SOX regimen； CapeOX regimen； Oxaliplatin； Tegafur； Capecitabine； Metastatic colorectal cancer； Cost-effective ness analysis |
| 阅读数： | 1238 次 |
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