论文部分内容阅读
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 investigate the effects of two adjuvant chemotherapy regimens for breast cancer: AC-T regimen (doxorubicin + cyclophosphamide-docetaxel), AC-TH regimen (doxorubicin + cyclophosphamide-trastuzumab + Docetaxel) for pharmacoeconomic evaluation. Methods The Markov model was established according to the four states of disease stability, disease remission, disease progression and death. The total cost of the two schemes was determined based on the charging standard of a top three hospital in Guangzhou, and the cost-effectiveness analysis was carried out. The results Conduct sensitivity analysis and find the optimal solution. Results The total cost of treatment for AC-T and AC-TH regimens was 92 490.03 yuan and 409 271.85 yuan respectively. The QALYs of the two regimens were 11.45 QALYs and 14.28 QALYs, respectively. Combined with trastuzumab The cost-effective ratio (ICER) after MAb was 111 937.04 yuan / QALY. Sensitivity analysis results are stable and do not affect the model analysis structure. Conclusion ACER is more than willingness to pay when compared with AC-T and AC-TH is the preferred option in terms of cost-effectiveness analysis.