Bootstrap法对顺铂为基础晚期食管癌化疗短期疗效的经济学分析

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目的:用Bootstrap法对3种顺铂为基础的联合化疗方案在晚期食管癌化疗短期疗效进行药物经济学分析。方法:采用回溯法筛选114例食管癌病例,分成3组,分别为Ⅰ组丝裂霉素、氟尿嘧啶联合顺铂(PMF)方案,Ⅱ组紫杉醇联合顺铂(TD)方案,Ⅲ组依托泊苷、氟尿嘧啶联合顺铂(PEF)方案。比较3组疗效及成本-效果比,用Bootstrap方法分析结果。结果:3组疗效分别为46.15%,47.36%,43.24%。成本-效果比(元/例)分别为36 677,42 345,37 946。以成本最低的Ⅲ组为对照,I组和II组的增量费用效果比(ICER)分别为17 828,85 512。同样以PEF方案为对照进行Bootstrap分析,两组的ICER的平均值分别为17 355,88 118,表明敏感性分析结果稳定性好,可信性高。结论:PMF方案积具有较好的药物经济学意义。 OBJECTIVE: To conduct a pharmacoeconomic analysis of three cisplatin-based combination chemotherapy regimens with Bootstrap in the short-term efficacy of advanced esophageal cancer chemotherapy. Methods: 114 cases of esophageal cancer were screened retrospectively and divided into 3 groups: group Ⅰ mitomycin, fluorouracil plus cisplatin (PMF), group Ⅱ paclitaxel plus cisplatin (TD), group Ⅲ etoposide , Fluorouracil plus cisplatin (PEF) regimen. The efficacy and cost-effectiveness ratio of three groups were compared, and the results were analyzed by Bootstrap method. Results: The efficacy of the three groups were 46.15%, 47.36% and 43.24% respectively. The cost-effectiveness ratio (yuan / case) were 36 677,42 345,37 946 respectively. With the lowest cost group III as a control, the incremental cost-effectiveness ratios (ICER) of Groups I and II were 17 828,85 512 respectively. Bootstrap analysis was also performed using the PEF regimen as a control, with mean ICER values ​​of 17 355 and 88 118 for both groups, indicating good sensitivity and stability of the sensitivity analysis. Conclusion: PMF program product has a good pharmacological significance.
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