SOX方案对比CapeOX方案治疗转移性结直肠癌的成本-效果分析 点击下载
论文标题: SOX方案对比CapeOX方案治疗转移性结直肠癌的成本-效果分析
英文标题:
中文摘要: 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。
英文摘要: 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
英文作者: 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
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