| HER-2阳性乳腺癌患者2种新辅助化疗方案的药物经济学评价 |
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| 引用本文： | 徐巧萍,朱洁瑾,刘坚,陈凌亚,骆瑛,史长城,李杨玲,谭笔琴,严伟.HER-2阳性乳腺癌患者2种新辅助化疗方案的药物经济学评价[J].中国现代应用药学,2019,36(8):985-992. |
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| 作者姓名： | 徐巧萍 朱洁瑾 刘坚 陈凌亚 骆瑛 史长城 李杨玲 谭笔琴 严伟 |
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| 作者单位： | 浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江省肿瘤医院, 杭州 310022,杭州市老年病医院, 杭州 310022,浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江大学医学院附属杭州市第一人民医院, 杭州 310006,浙江大学医学院附属杭州市第一人民医院, 杭州 310006 |
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| 摘 要： | 目的 对乳腺癌新辅助化疗方案多柔比星联合环磷酰胺序贯紫杉醇和曲妥珠单抗（AC-TH方案）及多西他赛联合卡铂和曲妥珠单抗（TCH方案）进行药物经济学分析，为该病治疗的选择提供决策依据。方法 建立Markov模型，对接受AC-TH与TCH新辅助化疗方案的患者进行模拟，综合应用临床试验研究结果、其他公开发表的文献和两大型综合性医院的病例资料，评价2种化疗方案的成本效果比，并进行敏感度分析。结果 成本效果分析显示，TCH组治疗乳腺癌的5年健康结果值为3.6质量调整生命年（quality-adjusted life years，QALYs），比AC-TH组多0.2QALYs；AC-TH组的成本为207 987元，比TCH组多45 940元，增量成本-效果比为-229 700元/QALY。结论 从中国医疗卫生体系角度出发，5年内新辅助化疗方案TCH比AC-TH对Her-2阳性乳腺癌患者更具成本效果比。
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| 关 键 词： | 乳腺癌 新辅助化疗 药物经济学 Markov模型 成本效果分析 |
| 收稿时间： | 2018/8/8 0:00:00 |
Cost-effectiveness Analysis of Two Neoadjuvant Chemotherapy in HER2-positive Breast Cancer Patient |
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| XU Qiaoping,ZHU Jiejin,LIU Jian,CHEN Lingy,LUO Ying,SHI Changcheng,LI Yangling,TAN Biqin and YAN Wei.Cost-effectiveness Analysis of Two Neoadjuvant Chemotherapy in HER2-positive Breast Cancer Patient[J].The Chinese Journal of Modern Applied Pharmacy,2019,36(8):985-992. |
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| Authors: | XU Qiaoping ZHU Jiejin LIU Jian CHEN Lingy LUO Ying SHI Changcheng LI Yangling TAN Biqin and YAN Wei |
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| Institution: | Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China,Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China,Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China,Zhejiang Cancer Hospital, Hangzhou 310022,Hangzhou Senile Hospital, Hangzhou 310022, China,Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China,Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China,Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China and Department of Pharmacy, Hangzhou First People''s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China |
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| Abstract: | OBJECTIVE To analyze the cost-effectiveness of doxorubicin/cyclophosphamide/paclitaxel/trastuzumab (AC-TH) and docetaxel/carboplatin/trastuzumab(TCH). METHODS A Markov model was built to simulate the process of breast cancer events and death occurred in both AC-TH and TCH armed patients and to choose a suitable chemotherapy method. Data were collected from the clinical trials, some publicized literatures and patients'' diaries of a large Chinese comprehensive hospital. The cost-effectiveness analysis of two regimens and sensitivity analysis were performed using a Markov model. RESULTS The 5 years'' results showed that patients receiving TCH gained 3.6 (quality-adjusted life years, QALYs) which were 0.2 QALYs more than patients receiving AC-TH. The ICER value was -229700 Yuan/QALY. The costs of patients receiving AC-TH were 207 987 Yuan which were 45 940 Yuan more than that of TCH. CONCLUSION Compared with AC-TH regimen, TCH can be viewed as cost-effective for breast cancer patients in 5 years horizon from a Chinese health system perspective. |
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| Keywords: | breast cancer neoadjuvant chemotherapy pharmaceutical economics Markov model cost-effectiveness analysis |
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