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基于Markov模型对我国晚期胰腺癌3种化疗方案的药物经济学研究
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| 篇名： | 基于Markov模型对我国晚期胰腺癌3种化疗方案的药物经济学研究 |
| TITLE： | |
| 摘要： | 目的：评价吉西他滨（G）、吉西他滨联合奥沙利铂（GM）、吉西他滨联合替吉奥（GS）3种方案治疗晚期胰腺癌的经济性。方法：本研究从患者角度出发，构建Markov模型，对我国18～75岁晚期胰腺癌患者接受3种化疗方案的长期成本和健康产出进行计算；采用成本-效果分析等方法，结合意愿支付水平（WTP）判断其经济性，并进行敏感性分析。结果：成本-效果分析结果显示，G方案治疗晚期胰腺癌患者成本-效果比（C/E）为145 228.52元/12.26 质量调整生命月（QALMs）， GM方案的C/E为154 783.88元/11.39 QALMs， GS方案的C/E为315 485.28元/23.26 QALMs，G方案为优选方案。增量成本-效果（ICER）分析结果显示， GS与G方案的ICER为15 479.64，超过本研究设定的WTP（12 563元）；而GM与G方案的ICER为－10 999.89，GM属于绝对劣势的方案。敏感性分析结果表明，G方案vs.GM方案的ICER结果不稳定，受模型中的参数影响较大；而G方案vs.GS方案和GM方案vs.GS方案对比的ICER分析结果均较为稳定。G方案较GS方案更具成本-效果；GM方案虽然较GS方案更具经济性，但是优越性相对不明显。结论：在意愿支付水平内，成本-效果分析结果显示吉西他滨单药治疗为最优方案，但敏感性分析结果尚不能确定哪一种方案为最优方案。 |
| ABSTRACT： | OBJECTIVE： To evaluate the economical efficiency of gemcitabine （G）， gemcitabine combined with oxaliplatin （GM）， gemcitabine combined with S-1 （GS） in the treatment of advanced pancreatic cancer （APC）. METHODS： From the perspective of patients， Markov model was constructed to calculate long-term cost and health outcomes of 3 chemotherapy regimens in Chinese APC patients aged 18-75 old. Cost-effectiveness analysis were used to determine the economic level according to willingness-to-pay （WTP）. The sensitivity analysis was conducted for cost， effectiveness and other indexes. RESULTS： The results of cost-effectiveness analysis showed that the cost effectiveness ratio （C/E） of G regimen in the treatment of advanced pancreatic cancer was 145 228.52 yuan/12.26 QALMs； C/E of the GM regimen was 154 783.88 yuan/11.39 QALMs； C/E of GS regimen was 315 485.28 yuan/23.26 QALMs； and the G regimen was the best option. The incremental cost-effectiveness （ICER） of GS and G regimen was 15 479.64， exceeded the WTP （12 563 yuan） set in this sutdy， while ICER of GM and G regimen was －10 999.89， and the GM regimen was absolutely inferior. Results of sensitivity analysis showed that ICER of G regimen vs. GM regimen was unstable and influenced greatly by the parameters of the model. Results of ICER analysis of G regimen vs. GS regimen and GM regimen vs. GS regimen kept stable. Compared to GS regimen， G regimen showed cost-effectiveness characteristics and GM regimen showed economic characteristics； the superiority was relatively less obvious. CONCLUSIONS： Within the level of WTP， cost-effectiveness analysis shows that gemcitabine is the optimal solution. However， sensitivity analysis result can not yet determine which scheme is the best one. |
| 期刊： | 2018年第29卷第6期 |
| 作者： | 汤少梁，陈文静 |
| AUTHORS： | TANG Shaoliang，CHEN Wenjing |
| 关键字： | 晚期胰腺癌；Markov模型；成本-效果分析；敏感性分析 |
| KEYWORDS： | Advanced pancreatic cancer； Markov model； Cost-effectiveness analysis； Sensitivity analysis |
| 阅读数： | 433 次 |
| 本月下载数： | 9 次 |
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