非小细胞肺癌三种化疗新方案的药物经济学评价  

Pharmacoeconomic analysis of three new chemotherapeutic regimens for non-small cell lung cancer

作　　者：范黎[1] 任军[1] 刘文超[1] 李永琦[1] 葛乐[1] 盛蓉[1] 张燕军[1] 朱延光[1] 

机构地区：[1]第四军医大学西京医院肿瘤科,西安710032

出　　处：《中国肺癌杂志》2002年第1期54-57,共4页Chinese Journal of Lung Cancer

摘　　要：目的　从药物经济学角度出发 ,对中晚期非小细胞肺癌 (NSCLC)三种化疗新方案进行分析评价 ,为临床合理用药提供参考。方法　采用药物经济学费用—效果分析法对 1 0 1例中晚期NSCLC的三种化疗方案 ,泰素 +顺铂 (paclitaxel+DDP ,PC) ,泰索帝 +顺铂 (docetaxel+DDP ,TC) ,以及诺维本 +顺铂 (vinorelbine+DDP ,VC) ,进行临床病例的回顾性分析比较。结果　PC、TC和VC组的有效率分别为 46.9%、48.6%和47.1 % ;中位生存期分别为 7.8、7.5和 7.6月 ;1年生存率分别为 37.5 %、37.1 %和 38.2 % ;PC组的有效率、中位生存期与TC组比较有显著性差异 (P <0 .0 5) ,但与VC组比较则无显著性差异 (P >0 .0 5) ;三组间 1年生存率无显著性差异 (P >0 .0 5)。三方案的 1个化疗周期人均总费用分别为人民币 1 5 840 .5、1 5 831 .1和 940 1 .8元 ;有效率每增加 1个百分点所需费用分别为 337.75、32 5.74和 1 99.61元 ;中位生存期每延长 1个月的成本为2 0 30 .83、2 1 1 0 .97和 1 2 37.0 8元 ;1年生存率每提高 1个百分点需支出的人民币分别为 42 2 .41、42 6 .71和2 4 6 .1 2元。结论　在中晚期NSCLC的 3种化疗新方案中 ,VC的费用明显低于PC和TC方案 。Objective To evaluate three new chemotherapeutic regimens for non small cell lung cancer (NSCLC) by pharmacoeconomic analysis in guiding rational use of drugs. Methods One hundred and one cases of NSCLC in clinic stage Ⅲ or Ⅳ were treated by one of the three chemotherapeutic schemes PC: paclitaxel (135?mg/m 2,d1)+DDP; TC: docetetaxel (75?mg/m 2,d1)+DDP; VC: vinorelbine (25?mg/m 2,d1 and d8)+DDP, DDP were given at 80?mg/m 2 in 3 groups. Pharmacoeconomic cost effectiveness analysis was used to compare the efficacy of the three regimens. Results The response rate was 46.9%, 48.6% and 47.1% and median survival duration was 7.8, 7.5 and 7.6 months for PC, TC and VC regimen respectively, with 1 year survival rate of 37.5%, 37.1% and 38.2% respectively. There was remarkable difference in the response rate and median survival duration between PC and TC, but no statistical difference was observed between PC and VC. There was no statistical difference in 1 year survival rate among the three regimens. The average cost of one patient for one therapeutic cycle was $15?840.5, 15?831.1 and 9?401.8 Yuan respectively. Escalation of 1% of response rate costed $337.75, 325.74 and 199.61 Yuan respectively. Prolongation of 1 month of median survival duration costed $2?030.83, 2?110.97 and 1?237.08 Yuan respectively. Escalation of 1% of one year survival rate costed $422.41 , 426.71 and 246.12 Yuan respectively. Conclusion Among these three new chemotherapeutic regimens for the advanced patients with NSCLC, the expenditure of VC is much cheaper than PC and TC. The cost effectiveness of VC is the lowest among the three regimens.

关 键 词：药物经济学 非小细胞肺癌 费用-效果分析 化疗 NSCLC 泰素 顺铂 泰索帝 诺维本 

分 类 号：R734.2[医药卫生—肿瘤]