标准一线化疗增加西妥昔单抗在晚期非小细胞肺癌患者中的成本-效果分析  

Cost-effectiveness of first-line chemotherapy with cetuximab for patients with advanced non-small-cell lung cancer

作　　者：刘家稳[1] 万小敏[1] 刘健[1] 赵子影[1,2] 王思颖[1,2] 

机构地区：[1]中南大学湘雅二医院药学部,长沙410011 [2]中南大学药学院,长沙410013

出　　处：《中南药学》2013年第10期778-780,788,共4页Central South Pharmacy

摘　　要：目的从中国医疗卫生角度出发,评价一线化疗加入西妥昔单抗在晚期非小细胞肺癌患者中的成本效果。方法根据晚期肺癌患者疾病发展情况建立Markov模型,将模型分为稳定态、进展状态和死亡状态;用TreeAge Pro Suite 2009软件计算增量成本效果比,并对结果进行敏感度分析。结果西妥昔单抗组与标准化疗组相比,ICER为487 818.8元/质量调整生命年;一元敏感度分析结果显示,西妥昔单抗的成本和进展状态的效用值对模型影响最大,其他参数对模型影响较小。敏感度分析结果显示模型结构稳定,研究结果可靠。结论从中国医疗卫生角度出发,相对标准化疗,晚期非小细胞肺癌患者一线化疗加入西妥昔单抗不具有成本效果性。Objective To evaluate the cost-effectiveness of adding cetuximab to first-line chemotherapy for patients with advanced non-small-cell lung cancer, from the perspective of the Chinese health care system. Methods A Markov model was built based on the natural history of advanced non-small-cell lung cancer, which was composed of 3 mutually exclusive health states： stable, progressive survival and death. The model was rolled back on TreeAge Pro Suite 2011. One-way analysis was performed. Results According to the model, the incremental cost-effectiveness ratio of cetuximab compared with standard first-line chemotherapy regimens was 487 818.8 yuan per quality-adjusted life-year gained. The one-way sensitivity analysis showed the cost of gefitinib had a remarkable influence, followed by the cost of best supportive care. The results were robust to key parameters in one-way sensitivity analysis. Conclusion Cetuximab is not cost-effective in advanced non-small-cell lung cancer.

关 键 词：西妥昔单抗 成本-效果 非小细胞肺癌 敏感度分析 

分 类 号：R956[医药卫生—药学]