三种联合用药方案治疗宫颈癌的药物经济学评价  

Pharmacoeconomic Evaluation of Three Combination Therapy of Cervical Cancer

作　　者：李正红[1] 王燕霞[1] 余黄鹏 戴星[1] LI Zhenghong;WANG Yanxia;YU Huangpeng;DAI Xing(The Fourth Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330002,China;The Third People’s Hospital of Jiujiang,Jiujiang Jiangxi 332005,China)

机构地区：[1]南昌大学第四附属医院,江西南昌330002 [2]九江市第三人民医院,江西九江332005

出　　处：《药品评价》2024年第7期865-868,共4页Drug Evaluation

基　　金：江西省教育厅科学技术研究项目(GJJ210255)。

摘　　要：目的在决策树模型的基础上对宫颈癌化疗的药物进行药物经济学评价,确定期望成本最低、效果最佳的宫颈癌化疗方案,以期为临床宫颈癌化疗药物的合理搭配提供决策依据。方法采用决策树模型对顺铂+紫杉醇脂质体,拓扑替康+紫杉醇脂质体和顺铂+紫杉醇脂质体+贝伐珠单抗三种用药方案治疗宫颈癌进行成本-效果分析,成本参数来源于九江市第三人民医院药品信息系统,同时根据本项目的随机对照研究所获取的化疗效果参数评估三种化疗方案短期内的经济性,决策树模型模拟的干预时间为12周。采用Treeage Pro 2011软件进行概率敏感性分析(成本-效果可接受曲线)和单因素敏感性分析(旋风图),对研究结果进行稳健性验证。结果基础分析结果表明,顺铂+紫杉醇脂质体的增量成本-效果比为12329.8,顺铂+紫杉醇脂质体+贝伐珠单抗的增量成本-效果比为36290.9,拓扑替康+紫杉醇脂质体的增量成本-效果比为19113.7。单因素敏感性分析结果显示,顺铂+紫杉醇脂质体的治疗成本和临床有效率对研究结果有最显著影响;当患者的个人意愿支付价格低于7376.6元时,顺铂+紫杉醇脂质体干预方案更具有经济性;当患者个人意愿支付价格高于7376.6元后,使用拓扑替康+紫杉醇脂质体治疗宫颈癌更具有经济性。结论若以2022年人均可支配收入作为患者个人意愿支付价格,宫颈癌患者选用顺铂+紫杉醇脂质体方案治疗最具有经济性。Objective To evaluate the economics of chemotherapy drugs for cervical cancer based on the decision tree model,and to determine the optimal chemotherapy regimen with the lowest cost and the best effect,so as to provide decision-making basis for the rational collocation of clinical chemotherapy drugs for cervical cancer.Methods The decision tree model was used to analyze the cost-effectiveness of cisplatin+paclitaxel liposome vs topotecan+paclitaxel liposome vs cisplatin+paclitaxel liposome+bevacizumab in the treatment of cervical cancer.The cost parameters were obtained from the drug information system of the Third People's Hospital of Jiujiang.The short-term economy of the three chemotherapy regimens was evaluated according to the chemotherapy effect parameters obtained from the randomized controlled study.The intervention time simulated by the decision tree model was 12 weeks.Probabilistic sensitivity analysis(cost-effectiveness acceptability curve)and single factor sensitivity analysis(whirlwind plot)were used to verify the robustness of the study results by using TreeAge Pro 2011 software.Results The results of basic analysis showed that the incremental cost-effectiveness ratio(ICER)of cisplatin+paclitaxel liposome was 12329.8,and that of cisplatin+paclitaxel liposome+bevacizumab was 36290.9,topotecan+paclitaxel liposome was 19113.7.Univariate sensitivity analysis showed that the treatment cost and clinical efficiency of paclitaxel liposome+cisplatin had the most significant impact on the study results;when the willingness to pay(WTP)of patients was lower than 7376.6 yuan,the therapeutic schedule of paclitaxel liposome combined with cisplatin was more economical;when the WTP of patients is higher than 7376.6 yuan,it is more economical to use paclitaxel liposome+topotecan to treat cervical cancer.Conclusion If the per capita disposable income in 2022 is taken as the patient's individual WTP,cisplatin+paclitaxel liposome is the most economical treatment for patients with cervical cancer.

关 键 词：化疗药物 宫颈癌 药物经济学评价 成本-效果分析 

分 类 号：R737.33[医药卫生—肿瘤] R956[医药卫生—临床医学]