曲妥珠单抗联合化疗用于乳腺癌辅助治疗的药物经济学评价  

Pharmacoeconomic Evaluation of Trastuzumabin Adjuvant Treatment for Breast Cancer

作　　者：邓小莹[1] 周晓虹[1] 陈洁[1] 李国豪[1] 

机构地区：[1]广州市第一人民医院,广东广州510180

出　　处：《今日药学》2017年第8期560-563,共4页Pharmacy Today

基　　金：广州市医药卫生科技项目(20141A010011);广东省医院药学研究基金(2015A07)

摘　　要：目的对两种乳腺癌辅助治疗方案:AC-T方案(多柔比星+环磷酰胺-多西他赛)、AC-TH方案(多柔比星+环磷酰胺-曲妥珠单抗+多西他赛)进行药物经济学评价。方法根据疾病稳定、疾病缓解、疾病进展和死亡4种状态,建立马尔可夫(Markov)模型,以广州市某三甲医院的收费标准确定两种方案的总成本,进行成本效果分析,并对结果进行敏感度分析,发现最优方案。结果 AC-T方案和AC-TH方案的治疗总成本分别为92 490.03元及409 271.85元;两种方案所获得的生命质量调整年(QALYs)分别为11.45 QALYs及14.28 QALYs;联用曲妥珠单抗后的增量成本效果比(ICER)为111 937.04元/QALY。敏感度分析结果稳定,不影响模型分析结构。结论 AC-TH方案与AC-T方案相比,ICER超过支付意愿,从成本效果分析看来,AC-TH方案为优选方案。OBJECTIVE To perform a pharmacoeconomic evaluation of Trastuzumab in adjuvant treatment for early breast cancer.METHODS Built a Markov state transition model to simulate the dynamic changes of the four disease states（ including stable disease,disease remission,disease progression and death） in patients who received AC-T therapy or AC-TH therapy with early breast cancer. The costs of these two therapies were calculated according to the charging standard of a third-level grade-A hospital in Guangzhou city.One way sensitivity analysis was carried out then. RESULTS The costs of AC-T therapy and AC-TH therapy were 92 490.03 Yuan and 409 271.85 Yuan,respectively.The model showed that quality-adjusted life-years（ QALYs） of AC-T therapy and AC-TH therapy were 11.45 QALYs、14.28 QALYs,respectively. An incremental cost-effectiveness ratio（ ICER） of 111 937. 04 Yuan/QALY gained. CONCLUSION Compare with AC-T therapy,the ICER of AC-TH therapy is out of pay,but as to cost-effectiveness analysis,AC-TH therapy is the preferred option.

关 键 词：乳腺癌 曲妥珠单抗 马尔可夫模型 成本效果分析 

分 类 号：R956[医药卫生—药学]