聚乙二醇脂质体阿霉素联合化疗方案治疗复发性卵巢癌的成本-效果分析  

Cost-effectiveness analysis of pegylated liposomal doxorubicin combined with chemotherapy in the treatment of recurrent ovarian cancer

作　　者：张琪琳[1] 丁玉峰 秦琰杰 戴冰 舒亚民 ZHANG Qi-lin;DING Yu-feng;QIN Yan-jie;DAI Bing;SHU Ya-min(Department of Pharmacy,Affilia-ted Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430022,China;Department of Pharmacy,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430030,China;West China Pharmaceutical College,Sichuan University,Sichuan Chengdu 610041,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,湖北武汉430022 [2]华中科技大学同济医学院附属同济医院药学部,湖北武汉430030 [3]四川大学华西药学院,四川成都610041

出　　处：《中国医院药学杂志》2021年第22期2322-2327,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家重点研发计划资助项目(编号:2017YFC0909900)。

摘　　要：目的:评价聚乙二醇脂质体阿霉素+贝伐珠单抗+卡铂(CD-BEV)化疗方案与吉西他滨+贝伐珠单抗+卡铂(CG-BEV)化疗方案治疗复发性卵巢癌的经济性。方法:基于已发表的一项Ⅲ期临床随机对照试验,根据疾病发展过程建立Markov模型,将患者的疾病发展过程分为无进展状态、进展状态和死亡状态,对CD-BEV方案与CG-BEV方案进行成本-效果分析,并对模型结果的稳定性进行单因素敏感性分析和概率敏感性分析。结果:根据Markov模型分析结果,CD-BEV方案对比CG-BEV方案的增量成本-效果比(ICER)值为565 409.69元/QALY,高于中国居民意愿支付阈值(217 341.00元/QALY)。单因素敏感性分析结果显示:聚乙醇脂质体阿霉素成本、无进展状态效用值、进展状态效用值对成本-效果分析结果的影响最大;概率敏感性分析结果显示:ICER值大于WTP(3倍GDP)的概率为100%。结论:与CG-BEV方案相比,CD-BEV方案治疗复发性卵巢癌不具有成本-效果优势。OBJECTIVE To explore the cost-effectiveness of carboplatin-pegylated liposomal doxorubicin-bevacizumab and carboplatin-gemcitabine-bevacizumab in the treatment of recurrent ovarian cancer.METHODS Based upon a published phase Ⅲ randomized clinical controlled trial, Markov model was established according to disease development process.The disease development process of patients with ovarian cancer was divided into non-progressive free survival, disease progression and death states.Cost-effectiveness analysis was performed between CD-BEV and CG-BEV and uncertainty of results was evaluated with single factor sensitivity and probability sensitivity analyses.RESULTS According to the results of Markov model, the ICER value in CD-BEV versus CG-BEV was 565 409.69 yuan/quality-adjusted life year(QALY)and it was higher than the domestic willingness-to-pay(WTP)threshold(217 341.00 yuan/QALY)without cost-effectiveness.One-way sensitivity analysis showed that cost of PLD,utility of PFS and utility of PD were the most predominant parameters in the model;and the results of probability sensitivity analysis indicated that the probability of ICER value higher than WTP(3 folds GDP)was 100%.CONCLUSION As compared with CG-BEV,CD-BEV offers no cost-effectiveness edge in the treatment of recurrent ovarian cancer.

关 键 词：聚乙二醇脂质体阿霉素 复发性卵巢癌 MARKOV模型 敏感性分析 成本-效果分析 

分 类 号：R956[医药卫生—药学]