3种止吐药物在晚期食管癌患者化疗中的药物经济学评价

目的：前瞻性研究本院帕洛诺司琼、阿扎司琼和托烷司琼对化疗引起恶心和呕吐的影响及对不同止吐方案进行成本-效果分析。方法：选取2018年1月~2019年12月间124例采用多西他赛+顺铂（DP）方案化疗的晚期食管癌患者作为研究对象，均签署知情同意书。将其随机分为3组（帕洛诺司琼组、阿扎司琼组和托烷司琼组）。在化疗前，分别给予相应药物预防止吐，通过MAT量表与FLIE量表对化疗相关恶心呕吐（CINV）情况进行评估，并基于医疗提供者角度，开展成本-效果分析。结果：3组抑制急性呕吐与恶心、延迟性呕吐与恶心方面，疗效比较无统计学差异（P>0.05）。住院期间抑制呕吐与恶心的药物成本，三种方案有统计学差异（P<0.05）。采用最小成本法，帕洛诺司琼成本最低，具有经济性。敏感性分析结果显示：缓解恶心和呕吐，帕诺洛司琼具有经济性概率始终最高。结论：帕诺洛司琼具有较好的经济性。

Pharmacoeconomic Evaluation of Three Antiemetic Drugs in Chemotherapy of Patients with Advanced Esophageal Cancer

Objective: To compare the effects of palonosetron, azasetron and tropisetron on chemotherapy-induced nausea and vomiting (CINV) and their cost-effectiveness. Methods: A total of 124 patients with esophageal tumors treated with docetaxel + cisplatin (DP) regimen were enrolled. They were randomly divided into three groups using palonosetron, azastatin or tropisetron, respectively, to inhibit vomiting. A pharmacoeconomic approach was applied to assess the differences among the three groups. Results: There were no significant differences in the efficacy of the three groups in the inhibition of CINV (P>0.05). Costs of drugs to suppress vomiting and nausea during hospitalization were statistically different among the three options. Using the least cost method, palonosetron showed to have the lowest cost and be economical. Sensitivity analysis results showed that palonosetron relieved nausea and vomiting, and had the highest economic probability. Conclusion: Palonosetron is more economical.