卡培他滨联合奥沙利铂治疗晚期或转移性结直肠癌的成本-效果分析

目的:对卡培他滨联合奥沙利铂(Cape OX方案)和5-氟尿嘧啶/亚叶酸钙联合奥沙利铂(m FOLFOX6方案)治疗晚期或转移性结直肠癌进行经济学评价。方法:基于Cape OX方案和m FOLFOX6方案治疗晚期或转移性结直肠癌疗效评价的Meta分析结果,各方案的终点结局为用药后不同疾病状态。以直接医疗成本进行成本计算,用Tree Age Pro软件构建决策树,进行成本-效果分析及敏感性分析。结果:与m FOLFOX6组比较,Cape OX组的成本-效果比值大,影响因素分析及单因素敏感性分析表明成本-效果分析的结果在有些情况下不太稳定,如采用国内品牌卡培他滨计算成本则Cape OX组的成本-效果比值小。结论:Cape OX组和m FOLFOX6组疗效相当,而成本-效果分析表明完成相应治疗周期后,采用国内品牌卡培他滨的Cape OX组更具有经济学优势。应用该结论时要注意相关概率和成本选择对结果稳定性的影响。

Cost-effectiveness Analysis of Capecitabine Combined with Oxaliplatin for Advanced or Metastatic Colorectal Cancer

OBJECTIVE： To evaluate the economic significance of capecitabine combined with oxaliplatin （CapeOX） and 5-fluorouracil/calcium folinate combined with oxaliplatin （mFOLFOX6） for advanced or metastatic colorectal cancer. METHODS： Based on Meta-analysis of efficacy evaluation of CapeOX and mFOLFOX6 treatment for advanced or metastatic colorectal cancer, different disease situations were induced after medication. Direct medical costs were adopted to calculate the cost of each regime; decision tree established with TreeAge Pro software to conduct cost-effectiveness analysis and sensitivity analysis. RESULTS： Com- pared with mFOLFOX6 regime, the C/E of CapeOX regime was higher. Influential factor analysis and single factor analysis showed that results of cost-effect analysis were not stable under some condition; if domestic capecitabine was used, the C/E of CapeOX regime would be lower. CONCLUSIONS： CapeOX and mFOLFOX6 regimes have similar efficacy; cost-effectiveness analysis shows that after treatment CapeOX regime has economic advantage based on domestic capecitabine. The effects of relative probability and cost selection on the stability of results should be considered when adopting the conclusion.